As a reminder to those who may have not read my posts in the past six
weeks, my PICOT question is: In patients with CHF, would a scheduled
education program with booklet versus just education handouts decrease
30 day hospital admissions over a 3 month period?” Heart failure
readmission rates cause the Center for Medicare and Medicaid Services to
now give hefty penalties to organizations within thirty days so there
is currently a tremendous amount of research surrounding this topic.
There are two major research studies that really follow the PET model
that I am aiming for with this study. My goal is to have approximately
60 test subjects from my primary care practice who fall within the
categories of having a low ejection fraction, diagnosed with heart
failure, and who do not have severe comorbidities including other
systems. I will split this group into a control group and an
intervention group. The control group will receive a three-month
educational program and booklet while the other will receive the
standardized care that has been used in the office.
The PDSA model was created by Edward Deming and is a
great way to implement change and improve quality of care. The PDSA
stands for Plan, Do, Act, and Study (Donnelly & Kirk, 2015). The key
through the literature research review was that patients’ who had
better education about their disease process, diet, exercise, lifestyle
modifications, medications, and treatment plan, ultimately had better
outcomes than those who are simply receiving the standardized care.
Through review of quantitative and qualitative research literature, it
was evident that the influence and key tools to self-management
precluded better patient outcomes, lower readmission rates, decrease in
length of stay in the hospital, and improved quality of life. Using the
PDSA model, I will outline my plan and figure out the ultimate goal of
this process. This PICOT question would require planning who will be
doing the education session, who will create the booklet, how we will
fund this project, and how to select as well as the selection process
for our test subjects (as well as informed consent). This also includes
the approval of an ethics committee for this research in order to
protect the test subjects. The “Do” would be to start the research
program by following the two groups and providing the education and
reference channels to the patients as see fit. It is important to
document throughout the course of this research in order to gain the
most information possible. The “Study” would be at the conclusion of the
three-month period when all the finalized data is collected and
analyzed. This is where the researcher would see if their predicaments
were correct and how they related to the research literature. The final
step is “Act” and this will involve assessing the overall cycle and
looking where to make changes to being the next PDSA cycle. In a world
of health care where it is constantly changing and evolving, it is
important that processes are being assessed in order to change and
improve. Following the three-month process of education, intervention,
and data collection, it is really important to focus on what worked
during the process, what didn’t, and what changes can be made to reach
the goal of healthier and happier patients.
One article I found had a very similar PICOT and used a
PET method that seemed very relevant to my PDSA. It used a similar
number of subjects and also slipt them into groups over a three month
period. It had very positive results in a sense that the patients who
were in the intervention group were very satisfied with their quality of
life and managed to stay out of the hospital. As nurses and a future
nurse practitioner, isn’t that what our goal of all this EBP is for – to
improve patient outcomes? I think to truly take my study one step
further would be to also perform a qualitative study and take a closer
look at their perception of the education, self-management, and possibly
ways to improve my program.
Alireza, A., Tahereh, N., & Mansoureh, A. (2018). Effect of the
self-management education program on the quality of life in people with
chronic heart failure: A randomized controlled trial. Electronic Physician, 10(7), 7028-7037. doi:10.19082/7028
Donnelly, P., & Kirk, P. (2015). Use the PDSA model for effective change management. Education
For Primary Care: An Official Publication Of The Association Of Course
Organisers, National Association Of GP Tutors, World Organisation Of
Family Doctors, 26(4), 279–281. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.
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In patients with CHF, would a scheduled education program with booklet versus just education handouts decrease 30 day hospital admissions over a 3 month period?” was first posted on November 6, 2020 at 2:22 pm.
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