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首页> 外文期刊>Journal of Nursing Education and Practice >Interventions to prevent heart failure readmissions: The rationale for nurse-led heart failure programs
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Interventions to prevent heart failure readmissions: The rationale for nurse-led heart failure programs

机译：用于预防心力衰竭的干预：护士LED心力衰竭计划的理由

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Background: Readmission to hospitals for heart failure is one of the greatest economic burdens on Medicare, and has become a major focus of healthcare reform. In an attempt to stem the overwhelming number of readmissions and improve heart failure outcomes, hospitals have employed multiple interventions. Nurse-led heart failure management programs have been an effective strategy in reducing hospital readmissions for heart failure. Purpose: We conducted an integrative review of the literature that assessed the value of interventions to reduce heart failure readmission rates. We focused on the important role of nursing care in successfully implementing many of these interventions. Methods: An integrative review of the literature was performed. A computerized search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library (reviews and clinical trials) was performed to locate articles published from 2004 to 2014. Key words used included “heart failure nursing”, “heart failure readmissions”, “heart failure programs” and “interventions for heart failure readmission”. Preference was placed on articles published in the last 10 years. Articles referenced by national heart failure guideline documents and expert consensus statements were given a high priority. Eighty-eight articles were screened initially by two reviewers; these were then screened to leave 40 relevant articles. Conclusions: Several specific interventions have a proven favorable effect in reducing heart failure readmissions. These include optimal medical management, patient education and self-care instruction, and ensuring adequate post-discharge follow-up. Despite this knowledge there remains a wide variation of readmission rates across the United States. This may be partly due to the variability in the adequate implementation of interventions and/or the absence of a required number of interventions in different centers. Each single intervention in itself has only a very small beneficial effect. The implementation of several interventions is essential to produce a meaningful reduction in heart failure readmissions. The ability to successfully employ numerous interventions together may explain the promising results of structured nurse-led heart failure programs.
机译：背景：心力衰竭的医院的入院是Medicare最大的经济负担之一，已成为医疗保健改革的重点。试图遏制压倒性的入伍，改善心力衰竭结果，医院采用了多种干预措施。护士主导的心力衰竭管理计划一直是减少医院入伍的心力衰竭的有效策略。目的：对文献进行了一项综述，评估了减少心力衰竭入住率的干预措施的价值。我们专注于护理在成功实施这些干预措施中的重要作用。方法：对文献进行综合审查。对护理，累计指数的电脑搜索有关护理和联盟健康文献（CINAHL）和Cochrane图书馆（Cochrane图书馆（评论和临床试验），以定位从2004年至2014年发布的文章。使用的关键词包括“心力衰竭护理”，“心脏失败入伍“，”心力衰竭计划“和”心力衰竭入读的干预“。偏好于过去10年发表的文章。国家心力衰竭指南文件和专家共识陈述引用的文章得到了高度优先事项。八十八篇文章最初被两名审稿人筛选;然后筛选这些以留下40条相关文章。结论：几种特定干预措施在减少心力衰竭入伍方面具有证实的有利影响。其中包括最佳的医疗管理，患者教育和自我护理指导，并确保充分放电后续随访。尽管如此，仍然存在仍然在美国的入院率差异。这可能部分是由于在不同中心的适当实施方面的变化和/或不需要不同中心的干预措施。每种干预本身都只有一个非常小的有益效果。实施多种干预措施对于在心力衰竭入院中产生有意义的减少至关重要。成功使用众多干预措施的能力可以解释结构化护士LED心力衰竭计划的有希望的结果。

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