Background Question

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PICO: (KEEP MY PICO QUESITION IN THE BACK OF YOU MIND, THE BACKGROUND QUESTION COMES BEFORE COMPOSING THE PICO)

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P: Does individuals 65 years and older with heart failure (P) benefit from nurse practitioner structured telephone support (I) while using current standard of care (C)by/which significantly increasing self-management, decreased patient readmission rate, education, medication compliance, etc. (O)?

Reference:

Inglis, S. C., Clark, R. A., Dierckx, R., Prieto-Merino, D., & Cleland, J. G. (2015). Structured telephone support or non-invasive telemonitoring for patients with heart failure. Cochrane Database of Systematic Reviews, 2015(10).

BACKGROUND QUESTION

This week we will focus on the one to two word topic you identified: HEART FAILURE Using this topic of interest, you will ‘tell me what you know’—creating your background question. You will post your background question discussing how you researched it. Post your background question and your strategy for getting a comprehensive understanding of the clinical issue. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources.

EXAMPLE:

The intensive care unit offers a diverse complexity of care to many critically ill patients. Due to the critical state of their health, many ICU patients require therapies and interventions, which extend prolonged periods of immobility (Phelan, Lin, Mitchell, & Chaboyer, 2018). Studies show that long stays within the intensive care unit can lead to an increased prevalence of infections and may be associated with deconditioning related comorbidities (Ronnebaum, Weir, & Hilsabeck, 2014). Immobility, due to prolonged time on mechanical ventilation, sedation, or rest may be the primary cause of general deconditioning of all body systems. Research has recognized that early mobilization of the intensive care unit patient is optimal for recovery, which ultimately decreases length of stay (Phelan et al., 2018). A background question may then be considered, which addresses how decreased mobility affects the recovery time of the adult ICU patient, which directly affects length of stay.

Findings within studies trialing early mobilization among critically ill patients found that patients treated with early mobilization require less days of mechanical ventilation and were subsequently discharged earlier from the ICU setting (Ronnebaum et al., 2014). Among patients with respiratory failure, early mobilization minimized ventilator dependency and increased functional capacity. These synergistic results demonstrated improved outcomes for the critically ill. These patients also endured better outcomes than those not mobilized. Recent literature confirms that providing mobilization services earlier among ICU patients may be directly linked to a reduction in hospital stays and a significant decline in potential ICU acquired comorbidity, which may decrease health care costs (Ronnebaum et al., 2014).

References

Phelan, S., Lin, F., Mitchell, M., & Chaboyer, W. (2018). Implementing early mobilization in the intensive care unit: An integrative review. International Journal of Nursing Studies, 77(1), 91-105. http://dx.doi.org/10.1016/j.ijnurstu.2017.09.019

Ronnebaum, J. A., Weir, J. P., & Hilsabeck, T. A. (2014). Earlier mobilization decreases the length of stay in the intensive care unit. Journal of Acute Care Physical Therapy, 3(2), 204-210. Retrieved from http://web.a.ebscohost.com.southuniversity.libproxy.edmc.edu

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