Elderly patients constitute some of the most vulnerable customers of any hospital. These individuals frequently lack the ability to take care of themselves, which results in the additional need for caregivers or a longer stay at a hospital. At Florida Keys Cardiology, patients’ health problems are concerned with heart diseases. The selected population for the education plan is composed of elderly patients suffering from heart failure. The desired outcome of the plan is the increased self-care ability of the identified population.
The Assessment of the Work Site
Florida Keys Cardiology does everything possible to manage its patients’ health needs and promote their full recovery. The present project involves the creation of a tertiary prevention education program aimed at enhancing the patients’ self-care abilities. The type of health promotion teaching that fits the organization best is the oral instruction given to patients by nurses accompanied by printed materials. The selected approach will be suitable both for patients and the nursing staff.
The Review of Literature
Scholars pay much attention to the problems of self care in heart failure patients. The study by Jaarsma et al. (2013) offers an extensive analysis of self-care behaviors of the selected population in fifteen countries. Scholars conclude that the majority of patients report the adherence to the medication regime. However, less than half of the patients that participated in the study keep the exercising regime and control their weight.
Meanwhile, cardiac rehabilitation exercises are regarded as a highly effective means of reducing the adverse outcomes of heart failure (Ades et al., 2013). Holden, Schubert, and Mickelson (2015) remark that some of the most common difficulties that patients meet when trying to meet the self-care needs include the complexity of tasks, timing, ambiguity, and undesirable results. Uchmanowicz, Wleklik, and Gobbens (2015) identify frailty syndrome as another barrier to patients’ successful self-care. Therefore, research indicates that an intervention is needed to increase patients’ self-care opportunities.
The Educational Plan
The education plan tailored to meet the needs of elderly patients with heart failure involves several steps. Both adherence to medication and lifestyle changes should be included in the plan, some of which include:
- quitting smoking;
- monitoring one’s weight daily;
- eliminating the consumption of alcohol;
- reducing cholesterol in one’s diet;
- eliminating fatty food;
- limiting the intake of fluid;
- following a low-sodium diet
- engage in regular physical exercises at a moderate intensity.
Statistics, Evidence-Based Knowledge, and Targeted Strategies
Targeted strategies include the increase of self-care value in patients and the enhanced understanding of their problems. Statistics pooled from fourteen samples indicate that over 50% of heart failure patients admit that their exercise levels are low (Jaarsma et al., 2013). Another set of samples gathered by Jaarsma et al. (2013) demonstrates that less than 50% of patients weigh themselves regularly. Ades et al. (2013) note that the adjusted risk for hospitalization or mortality is reduced when patients exercise regularly (hazard ratio: 0.89). Therefore, the targeted strategies will include the increased adherence to lifestyle changes. The most effective strategy seems to be engaging patients in exercising regularly and controlling their weight.
The first intervention will involve getting patients interested in exercising. To make this approach successful, it will be necessary to explain its positive examples and the effect it has had on other patients. This intervention is patient-centric and culturally sensitive since it is concerned with the specific understanding of elderly people’s problems when engaging in self care. Depending on the patients’ age and their ability to operate technical equipment, they can be recommended to download an application on their smartphone, which will enable them to monitor their progress. Those individuals that have difficulty using an app can track their activities in a notebook.
The second intervention concerns such lifestyle changes as smoking cessation and the reduction of fatty and high-cholesterol products in the diet. It is crucial to explain the importance of weight control to heart failure patients. Due to correct food choices, these individuals can eliminate the risk of a repeated hospitalization significantly. At the same time, it is necessary for these patients to understand that consuming unhealthy food can deteriorate their health.
Costs, Barriers, Time-Frame, and Evaluation
The costs involved in the project will not be high. Mostly, the education will be performed in the form of lectures and discussions between nurses and patients. Some additional expenditures will be needed to print out brochures containing the most necessary information concerned with exercising and weight control. The implementation of the plan will supposedly take a month, and another month will be needed for the follow-up observation. The evaluation will involve a comparison of the number of readmitted patients in the pre- and post-intervention period.
The Nursing Theory and Educational Method
The most appropriate nursing theory for this project is Orem’s theory self-caring. According to the concepts of this approach, the ability to look after oneself enhances people’s dignity and preserves their independence (McKenna, Pajnkihar, & Murphy, 2014). Thus, the theory is aimed at encouraging people to take care of themselves as much as possible and eliminating the use of additional support. The educational method is instructing patients by nurses along with the use of some printed materials.
Heart failure is a rather serious disease that can bring about complications unless treated appropriately. Apart from doctors’ efforts, patients need to take care of their health and engage in the self-caring behavior. The suggested education plan presupposes getting patients acquainted with the most effective self-care strategies. Controlling one’s weight and exercising are regarded as the most effective approaches. Interventions are aimed at enhancing patients’ self-care abilities and improving their health condition.
Ades, P. A., Keteyian, S. J., Balady, G. J., Houston-Miller, N., Kitzman, D. W., Mancini, D. M., & Rich, M. W. (2013). Cardiac rehabilitation exercise and self care for chronic heart failure. JACC: Heart Failure, 1(6), 540-547.
Holden, R. J., Schubert, C. C., & Mickelson, R. S. (2015). The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. Applied Ergonomics, 47, 133-150.
Jaarsma, T., Strömberg, A., Ben Gal, T., Cameron, J., Driscoll, A., Duengen, H.-D., … Riegel, B. (2013). Comparison of self-care behaviors of heart failure patients in 15 countries worldwide. Patient Education and Counseling, 92(1), 114-120.
McKenna, H., Pajnkihar, M., & Murphy, F. (2014). Fundamentals of nursing models, theories and practice (2nd ed.). West Sussex, UK: Wiley Blackwell.
Uchmanowicz, I., Wleklik, M., & Gobbens, R. J. J. (2015). Frailty syndrome and self-care ability in elderly patients with heart failure. Clinical Interventions in Aging, 10, 871-877.