Capella FPX 4025 Assessment 3

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Applying the PICO(T) Process

Acute Heart Failure (AHF) is a prominent global contributor to mortality, particularly in developed nations like the United States. Annually, nearly one million Americans are diagnosed with cardiovascular diseases, placing a significant burden on the healthcare system (Heidenreich et al., 2022). This paper focuses on the persistent issue of high hospital readmission rates among AHF patients. It evaluates evidence-based nurse-led interventions—particularly those focused on education and self-care—to determine their effectiveness in reducing readmissions and improving patient outcomes.

Understanding the Diagnosis

AHF is a severe and life-threatening condition that affects patients’ functional capabilities and daily living. Common symptoms include breathlessness, extreme fatigue, and fluid retention, which frequently lead to emergency admissions and deteriorating quality of life. The disease can progress into acute decompensated heart failure (ADHF), requiring specialized medical management. It is a leading cause of death across all racial, ethnic, and gender groups in the United States. The CDC reports that one person dies from a cardiovascular condition every 33 seconds, and in 2022 alone, heart failure accounted for 702,881 deaths—22% of the total mortality that year (CDC, 2024).

Older adults are particularly vulnerable to AHF due to aging-related conditions, multiple medications, and declining physical reserves. Racial disparities persist, with African American communities experiencing elevated hospitalization and death rates from AHF due to unequal healthcare access and systemic barriers (Hashem et al., 2024). Socioeconomic challenges further exacerbate outcomes among low-income populations, highlighting the critical need for equitable and timely healthcare interventions.

PICO(T) Research Question

The formulated PICO(T) question guiding this analysis is:

“In adults hospitalized with acute heart failure (AHF) (P), how does nurse-led patient education and self-care support (I), compared to standard discharge instructions alone (C), affect hospital readmission rates and symptom management (O) over 12 weeks (T)?”

PICO(T) Element	Description
P (Population)	Adults hospitalized with AHF who are at risk of poor outcomes due to limited self-care abilities.
I (Intervention)	Nurse-led education including structured discharge plans, monitoring signs, medication adherence, and lifestyle counseling.
C (Comparison)	Standard discharge instructions with minimal follow-up or personalized education.
O (Outcome)	Improvement in symptom control and reduced hospital readmissions.
T (Time)	A 12-week period post-discharge to assess the effectiveness of the intervention.

This PICO(T) question directs the focus of research toward assessing whether tailored nurse-driven education is more beneficial than standard discharge practices in managing symptoms and preventing readmissions in AHF patients.

Literature Search

A comprehensive literature search was conducted to identify studies examining nurse-led education and its impact on self-care among AHF patients. Databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar were searched using terms including “acute heart failure,” “self-care education,” “nurse-led interventions,” “heart failure readmissions,” and “patient education.” Boolean operators like AND/OR were applied to refine the results.

Search filters were applied to include only English-language, full-text peer-reviewed studies from the past five years. The CRAAP test (Currency, Relevance, Authority, Accuracy, and Purpose) was used to assess source credibility. Emphasis was placed on recent publications, systematic reviews, and clinical guidelines issued by reputable entities like the American Heart Association (AHA, 2021) and European Society of Cardiology (ESC, 2021). The refined scope ensured a focus on relevant, high-quality evidence to guide nurse-led patient education and self-care interventions in AHF.

Summary of Relevant Articles

The review uncovered several significant sources supporting nurse-led education in AHF care:

Study/Source	Findings	Credibility
Kaseb et al. (2024)	The teach-back method improved patient understanding, symptom tracking, and medication adherence.	Published in BMC Cardiovascular Disorders, a peer-reviewed journal.
Bernard et al. (2023)	Nurse-led programs with dietary and symptom recognition training significantly reduced readmission rates.	Found in Heart & Lung, supported by cardiology experts.
ESC Guidelines (2021)	Offered best practice standards on patient education and self-care in AHF.	Considered foundational and widely accepted in cardiology practice.
Bulto & Hendriks (2023)	Highlighted how structured education empowered patients, improved compliance, and reduced hospital visits.	Published in European Journal of Cardiovascular Nursing using robust review methods.

Evidence Analysis

The analyzed evidence supports the effectiveness of nurse-led educational interventions in enhancing self-care among patients with AHF. Kaseb et al. (2024) demonstrated that using the teach-back method helps patients—especially those with limited literacy—retain critical discharge instructions. Bernard et al. (2023) found that structured education encompassing dietary management, symptom monitoring, and follow-up visits significantly improved patient outcomes. The ESC (2021) guidelines reinforced the necessity of educational strategies as core components of AHF management. Bulto and Hendriks (2023) similarly highlighted how personalized education boosted treatment adherence and minimized readmissions. Collectively, these findings affirm the clinical value of integrating nurse-driven education into AHF care plans.

Conclusion

Nurse-led education and self-care strategies show significant promise in improving symptom control and lowering readmission rates for AHF patients. When integrated into the discharge planning process, these approaches empower patients to take an active role in their care. Given the growing burden of AHF, investing in nurse training and structured patient education is vital for fostering long-term positive outcomes.

References

American Heart Association. (2021). Heart failure. https://www.heart.org/en/health-topics/heart-failure

Bernard, T. L., Hetland, B., Schmaderer, M., Zolty, R., & Pozehl, B. (2023). Nurse-led heart failure educational interventions for patient and informal caregiver dyads: An integrative review. Heart & Lung, 59, 44–51. https://doi.org/10.1016/j.hrtlng.2023.01.014

Bulto, L., & Hendriks, J. (2023). The role of nurse-led intervention to empower patients in cardiovascular disease care. European Journal of Cardiovascular Nursing, 23(2). https://doi.org/10.1093/eurjcn/zvad095

Centers for Disease Control and Prevention. (2024, October 24). Heart Disease Facts. https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html

European Society of Cardiology. (2021, August 25). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure

Hashem, A., Khalouf, A., Mohamed, M. S., Nayfeh, T., Elkhapery, A., Zahid, S., Altibi, A., Thyagaturu, H., Kashou, A., Anavekar, N. S., Gulati, M., & Balla, S. (2024). Racial, ethnic and sex disparity in acute heart failure patients with COVID-19: A nationwide analysis. Heliyon, 10(15), e34513. https://doi.org/10.1016/j.heliyon.2024.e34513

Heidenreich, P. A., Fonarow, G. C., Opsha, Y., Sandhu, A. T., Sweitzer, N. K., & Warraich, H. J. (2022). Economic issues in heart failure in the United States. Journal of Cardiac Failure, 0(0), 453–466. https://doi.org/10.1016/j.cardfail.2021.12.017

Kaseb, A., Zeydi, A. E., Dovvombaygi, H., & Nazari, A. M. (2024). Effects of education based on teach-back methods on self-care and quality of life of the patients with heart failure: A systematic review. BioMed Central Cardiovascular Disorders, 24(1). https://doi.org/10.1186/s12872-024-04264-5