Research Proposal Draft
Heart failure has recently been declared a global pandemic as it is affecting millions and millions of people worldwide. The condition occurs when the heart fails to pump or fill with blood as it should. Heart failure is mostly associated with old people and it one of the major hospitalization cases among the elderly in the United States. Studies have also shown that not less than 27% of the discharged heart failure patients get readmitted within 30 days of discharge. The rates of mortality and morbidity of the condition is also on the increase despite efforts to reduce. This has cost health care systems a lot of money. Readmission is also expensive and hospitals have to meet penalties for the same. Heart failure has therefore become a national concern in the United States and a challenge for the researchers to find better treatments in order to improve patient care and reduce readmission.
Statement of Problem
We acknowledge that among the many patients who get readmitted only a few days after discharge majority of them are heart failure patients. It is also our concern that many of these readmitted patients end up losing their lives. The mortality rate increases with the readmitted patients that first time admissions. We have also realized that in many cases the readmitted patients may have additional infections other that the original reason for admission and this may be the cause of high mortality rates among the readmitted patients. This study seeks to understand the causes of early readmission and the reasons for many death cases for the readmitted. Specifically, the research seeks to understand the relationship between nurse staffing and the readmission rates.
Our research question therefore focuses on whether nurse staffing affects rates of readmission for heart failure patients. Nurses are very critical assets of any hospital. They have the knowledge and skills to administer the appropriate care to patients. They have a good understanding of what a patient care is required and how it should be accorded. It is, therefore, important that health facilities have adequate skilled nurses. Studies have shown that readmission occurs due to missed care or inappropriate medication.
Low nurse staffing is one of the causes of hospital 30 day readmission among heart failure patients. The research seeks to prove this point in an attempt to minimize the cases of early readmission through improving patient care. Nurses area key asset to any health institution due to their strong understanding of the care to accord to patients. Most studies have shown some of the readmission reasons to be poor hospital care and inappropriate medication. This could be attributed to unqualified care givers or insufficient qualified nurses to attend to all patients.
Many studies have shown poor patient outcomes when there is low nurse staffing (Blouin, A. S., & Podjasek, K., 2019). A nurse’s primary goal is to accord high quality care to the patients. Increasing nurses will there give a good opportunity for all patients to be attended to as required. It should also be noted that it is not just about increasing the number of nurses but focusing on acquiring qualified registered nurses. It becomes difficult to provide optimal care when there are few nurses. It also results in missed care which will lead to high chances of being readmitted early.
The study seeks to acquire data from top cardiovascular and heart surgery hospitals which will provide quality and reputable variables to be used for the research. Heart Failure is a condition that is mostly associated with old people mostly above 65 years of age. Readmission is, therefore, seen among the elderly. Our study variables will arise from the causes of readmission. Since our research focuses on the impact of nurse staffing, we will identify the critical roles of a qualified registered nurse in line with high quality care provisioning. Our major variable will, therefore, be the number of nurses in a health care facility, both qualified and unqualified, the average number of heart failure patients in a health facility over a given period of time, nurse-patient ratio, the average number of admissions and 30-day planned and unplanned readmission over the same period of time, the highest age bracket of readmission and the mortality rate after readmission.
In our research, early readmission (30-day readmission), means a patient is taken ill again within the first 30 days after discharge and has to be admitted again for treatment. It is a concern to look into because a well-treated patient should not be taken back to hospital as early as within the first 30 days after being discharged as it raises questions as to the quality of health care the patient received during the original admission. Unplanned readmission occurs when heart failure patient gets readmitted but was not being expected at the hospital or was not a directive for a medical practitioner. Planned readmission happens through a physician who may seen the patient condition and books to be readmitted for more care.
The study also focuses on nurse qualification and registration. Registered nurses are those who have gone through all the requirements of becoming a nurse and are registered under the appropriate bodies. Such nurses are considered qualified and are counted upon to provide high quality care (Giuliano, K. K., Danesh, V., & Funk, M., 2016). Unqualified nurses on the other hand are not yet registered and may not posses the right skills to accord the expected care. These could be interns who are yet to go through more training to be registered. Nurse-patient ratio gives the number of patients that one qualified nurse is expected to attend to if they were to be assigned. The higher the number of patients the more the accorded care is compromised. Rates of admission and readmission gives an average of patients that are admitted for the first time and those who are readmitted within 30 days. It is also important to average number of patients who die following readmission (readmission mortality rate).
Blouin, A. S., & Podjasek, K. (2019). The Continuing Saga of Nurse Staffing: Historical and Emerging Challenges. JONA: The Journal of Nursing Administration, 49(4), 221-227.
Giuliano, K. K., Danesh, V., & Funk, M. (2016). The Relationship Between Nurse Staffing and 30-Day Readmission for Adults With Heart Failure. The Journal of nursing administration, 46(1), 25–29.
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