Research In Nursing Assessment Answer

Task Instructions
1.    Read the case study which is in the Assessment 2 folder in the L@G site.
2.    Now read the sources in the Reference List and select three (3) journal articles that you will use for the annotated bibliography section of your assignment. Select the journal articles that you think relate the most to the clinical condition presented in the case study.
 

RESEARCH IN NURSING

PART 1: ANNOTATED BIBLIOGRAPHY

In the given case, Charlie who is 75 year old overweight man diagnosed with the chronic heart failure. Thus, on the basis of given aspect different references will be selected.
Murray, M. D., Tu, W., Wu, J., Morrow, D., Smith, F.&Brater, D. C. (2009). Factorsassociatedwithexacerbationofheartfailureincludetreatmentadherence and healthliteracyskills.Clinical Pharmacology and Therapeutics, 85, 651-658.

In the above-mentioned study, randomized controlled trials were used and the total population for the selected study is 1324. However, among this population selected sample were 192. This study was conducted at Wishadhealth services. Herein, with an aim to collect the data for the study for primary and secondary methods were taken into consideration. In this regard, secondary data was collected through Regenstrief Medical Records System with an aim to identify clinically stable patients from the medical practices which are internal. Here, those patients were included who was diagnosed with health failure. In terms of study design, interviews were conducted for an about 6-12 months. 

However, for the purpose to analyse data t-test and Chi-Square was applied in which comparison was carried out between those patients who had an emergency visit in hospital and patients who did not had emergency visit in hospital. 

Refill adherence of less than 40% was related with the high incidence of hospitalization of the heart failure. As per multivariate analysis, reading skill related with prescription label was associated with the lower incidences related to heart failure. 

The study concludes that the main factors in relation to exacerbation of heart failure are health literacy and inadequate treatment adherence.
Sagar, V. A., Davies, E. J., Briscoe, S., Coates, A. J. S.,Dalal, H. M., Lough, F., … Taylor, R. S. (2015). Exercise-based rehabilitation for heart failure: Systematic review and meta-analysis. Open Heart, 2, 1-12. 

In the given study, 33 trials of the study were conducted on 4740 patients. However, these were collected through randomizedtrail. The main aim of the given study was to updateCochrane systematic review of the exercise based cardiac rehabilitation for the patients with heart failure. For the data analysis purpose, systematic review and Meta analysis were taken into consideration. For data collection purpose different clinical studies were reviewed.In accordance with the given context, Cochrane library, EMBASE and MEDLINE was taken into purpose with an aim to assemble data for the current study with the use of secondary sources.In the similar way, Meta analysis and systematic review were the main methods for collection the primary data for the given study. Here, trials with 6 or more months of follow up were conducted.

However, from the conducted analysis it was found out that the exercise based CR reduces the risk of (RR 0.75; 0.62 to 0.92, 0.005). Further, the heart failure related hospitalization was also reduced from (RR 0.61; 0.46 to 0.80, 0.0004). Thus, from the conducted analysis it can be concluded that with the use of exercise based CR significant improvement in the hospitalization and health related quality of life will be carried out. Strömberg, A., Mårtensson, J., Fridlund, B., Levin, L-A., Karlsson, J-E., &Dahlström, U.(2003). Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: Results from a prospective, randomised trial.European Heart Journal, 24, 1014-1023.

This study was conducted on 106 patients who were randomly selected.  These selected patients were followed up by nurse led heart failure clinic or to the usual care. The main aim behind this study is to evaluate the effect of follow up at the nurse led heart failure clinic on self care behaviour, morbidity and mortality.This study was conducted upon patients who hospitalised due to heart failure and discharged from hospital after 12 months. 

Here, randomised study with 12 month follow up was conducted. Herein, permission for the same was taken from Regional Ethics Committee for HR at Sweden based University of Linkoping. The selling for the study was two country hospitals and one university hospitals. For the data collection purpose, medical reports of patients were considered for getting information about clinical and demographic data. However, with an aim to assess self care behaviour questionnaire were framed. Data was analysed with the help of t-test. It had been found out that intervention group had fewer admission in comparison to control group. Further, intervention group had higher self care score in comparison to control one.It had concluded that patients with heart failure survival and self care behavior were improved if nurse perform follow up after hospitalization. 

PART 2: JUSTIFICATION OF THE CHOICE OF SOURCES

All the selected sources are effective as these provide effective information with the help of which an effective care of the patients with heart failure will be carried out.The selected first source which was written by Murray and et.al (2009) depicts that there are various factors which are related with exacerbation of heart failure. Here, with the help of given study Charlie can examine the details in relation to its current medical condition. From the given case study, it is examined that Charlie was not feeling well. Thus, with the use of the result of given case study, Charlie can find out answer to the question that his poor health is the result of chronic heart failure and due to his poor physical health. 
Further, the case depict that Charlie is overweight and he is too old. Thus, in the age of 75 human should be balanced body mass index. However, if people will not take care about themselves then in the given situation they will be affected with the condition like heart failure. Here, the second study is related to exercise based rehabilitation for heart failure. Thus, their major advantage is that with the use of it Charlie can analyse the importance for doing exercise with an aim to reduce the risk of heart failure in an effective way. 

Besides this, in the third source major emphases is given upon the services which are being provided by nurse after discharge from hospital. Thus, with the help of given study role of nurse’s services in improving the clinical condition of Charlie will be carried out. Thus, these all are being regarded as the major strength of the conducted studies. From this it can also be concluded that the research as being conducted by all the authors are of high quality. This is because, these all are giving an appropriate answer to the questions which are associated with the heart failure in an effectual way. Thus, if these all will be applied in the practices at that time significant improvement in the health condition of patients like Charlie can be carried out. 

The study which was conducted by Murray and et.al (2009) depict that it is the responsibility of hospital that it should provide health literacy to the patients like Charlie. Here, the hospitals should also adhere to the inadequate treatments which are provided in hospital. In addition to this, the study of Sagar and et.al (2015) entails that the quality of health can be improved with regular exercise. Thus, from this it can be said that by doing small and simple exercise on regular basis Charlie can reduce its weight which is a major reason behind heart failure. Here, it is through this way Charlie can make improvement in its medical condition in an effectual manner. 

Besides this, Stromberg and et.al (2003) depict that the nurses who are treating Charlie should properly review its clinical condition. Herein, they should encourage self carebehavioramong Charlie. Further, they should also make effort in terms of helping Charlie in the process of reducing his weight. Through this way, significant improvement in the condition of Charlie will be carried out.

PART 3: RECOMMENDATION FOR CLINICAL PRACTICES

According to the view point of Yancy and et.al (2017)it is recommended to the hospital that they should constantly measure the activity of heart patient after discharge. Herein, they should judge their eating and other lifestyle practices. Nishimura and et.al.(2017) have stated that it is required by hospital that they should clearly mention their patients about do and do not things which they need to do after getting treatment of cardiovascular diseases. This thing will also cause positive impact on patients like Charlie (Bangalore and et.al.,2017). Thus, it will also reduce the admission of patients in hospital in relation to heart failure in an effectual way. Gerhard-Herman and et.al.(2017) have depicted that an individual should make changes in their diet and should live healthy life. Through this way, person can save itself from different diseases including heart failure (Komajda and et.al.,2017). Inglis and et.al.(2017) states thatit is required by nurses that they should examine past history of their patients. It is through this way only they can give their best services to the patients with heart failure in an effectual manner. As per Brown, Edwards & Buckley (2017)nurses should give advice to patients in relation to the reduction of weight. Through this way also case related with health failure can be reduced (Sanz-Ruiz and et.al.,2017). 

REFERENCE

Bangalore, S. and et.al.(2017). Renin angiotensin system inhibitors for patients with stable coronary artery disease without heart failure: systematic review and meta-analysis of randomized trials. bmj, 356, j4.
Brown, D., Edwards, H. & Buckley, T. (2017). Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems. Elsevier Health Sciences.
Gerhard-Herman, M. D. and et.al.(2017). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 135(12), e686-e725.
Inglis, S. C. and et.al.(2017). Structured telephone support or non-invasive telemonitoring for patients with heart failure.
Komajda, M. and et.al.(2017). Physicians' guideline adherence is associated with better prognosis in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. European journal of heart failure, 19(11), 1414-1423.
Nishimura, R. A. and et.al.(2017). 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 135(25), e1159-e1195.
Sanz-Ruiz, R. and et.al.(2017). Rationale and Design of a Clinical Trial to Evaluate the Safety and Efficacy of Intracoronary Infusion of Allogeneic Human Cardiac Stem Cells in Patients With Acute Myocardial Infarction and Left Ventricular DysfunctionNovelty and Significance: The Randomized Multicenter Double-Blind Controlled CAREMI Trial (Cardiac Stem Cells in Patients With Acute Myocardial Infarction). Circulation research, 121(1), 71-80.
Yancy, C. W. and et.al.(2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Journal of cardiac failure, 23(8), 628-651.