NR 716 Week 4 Translation Science and Synthesis

NR 716 Week 4 Translation Science and Synthesis

Student Name

Chamberlain University

NR-716: Analytic Methods

Prof. Name:

Date

Evidence Synthesis: Heart Failure

Heart failure (HF) is a progressive and multifaceted condition in which the heart is unable to pump blood effectively to meet the body’s oxygen and nutrient needs. This impaired cardiac output creates significant challenges in treatment and long-term management (Piña et al., 2021; Centers for Disease Control and Prevention [CDC], 2019). Congestive heart failure (CHF), a common subtype of HF, frequently develops due to modifiable lifestyle factors such as smoking, high-sodium and high-fat diets, physical inactivity, and excessive alcohol use (CDC, 2023; Mohammadi et al., 2021; Pereira Sousa et al., 2021; Ding et al., 2020). Additionally, comorbidities such as hypertension, obesity, diabetes, and coronary artery disease increase the risk of developing HF (Mohammadi et al., 2021; CDC, 2023).

Early preventive strategies—including timely diagnosis, patient education, and lifestyle modification—are essential to reducing HF-related morbidity and mortality. According to the World Health Organization (2021), early detection of cardiovascular disease supports faster initiation of therapy, which can significantly improve outcomes. Moreover, social and professional support has been shown to decrease patient anxiety, enhance adherence to therapy, and promote overall well-being (Singh et al., 2021).

This evidence synthesis reviews the national and state-level impact of HF, evaluates both research and non-research findings, and emphasizes the role of provider-led interventions such as multimedia education, teach-back strategies, and reflective learning. These approaches aim to improve patient self-care, reduce cardiac anxiety, and lower hospital readmission rates.

Analysis

CHF is among the leading causes of global mortality and disability. Patients managing this condition must acquire adequate knowledge about symptom monitoring, diet restrictions, medication schedules, exercise, and daily weight tracking (Mohammadi et al., 2021; Ding et al., 2020). While the heart continues to function in HF, compromised circulation reduces oxygen delivery to vital organs, resulting in frequent readmissions for patients who struggle with self-management.

Education remains a cornerstone of HF management, empowering patients to actively participate in their care and reducing the likelihood of hospitalizations (Pereira Sousa et al., 2021). Epidemiological studies show that approximately 6.7 million Americans aged 20 or older are diagnosed with HF, and this figure is projected to increase to 8.5 million by 2030 (CDC, 2023). Globally, HF incidence ranges between 1–9 per 1,000 people annually, with the risk rising significantly after age 55 (Groenewegen et al., 2020).

Racial disparities in HF outcomes are notable. In 2020, African Americans had the highest mortality rates from HF (675.4 per 100,000) compared to Hispanics (154.8 per 100,000) at the state level (CDC, 2020). National data also reveal disparities, with African Americans experiencing 571.8 deaths per 100,000 compared to 315.5 per 100,000 in Hispanics (Mujib et al., 2011). Mortality is particularly concentrated in southern states such as Alabama and Mississippi, referred to as the “heart failure belt” (CDC, 2020).

The economic impact is equally concerning. On average, managing HF in the United States costs approximately $30,000 per patient annually (Heidenreich et al., 2022). Without effective interventions, these costs will rise due to repeated hospitalizations and long-term care needs. Patient-centered education, consistent follow-up, and robust support systems are cost-effective strategies that can improve outcomes while alleviating financial strain.

Evidence Synthesis

A review of three randomized controlled trials (RCTs) demonstrates that poor self-care and insufficient support remain the main barriers in HF management. However, interventions incorporating technology, teach-back, daily symptom monitoring, and reflective learning consistently improved outcomes (Mohammadi et al., 2021; Ding et al., 2020).

Comparative Summary of the Three Studies

Despite differences in study design and interventions, the findings consistently highlight the value of continuous provider support and interactive education. Technology-assisted learning and reflective strategies foster patient empowerment, leading to improved self-management and clinical outcomes.

Practice Question

In patients aged 18–60 with heart failure (P), how does multimedia education with teach-back and reflective learning (I), compared to multimedia education alone (C), influence patient anxiety, hospital readmission, and quality of life (O) within an 8–10 week timeframe (T)?

Evidence indicates that structured discharge education combined with follow-up significantly lowers readmission rates and improves self-management (Rahmani et al., 2020). The integration of reflective learning ensures patients not only receive information but also internalize it, promoting long-term adherence and enhanced quality of life.

Translation Science Theory

The Knowledge-to-Action (KTA) framework provides the foundation for implementing these evidence-based practices in HF care. The framework connects theoretical evidence with real-world clinical application (Lee & Ho, 2019).

Application of the KTA Framework

• Knowledge Creation: Identifying the knowledge gap in HF self-management and emphasizing education.

• Adaptation: Tailoring multimedia education and reflective strategies into discharge plans.

• Barrier Assessment: Recognizing issues such as limited patient understanding, poor health literacy, and lack of support.

• Implementation: Delivering education through teach-back and reinforcing it with follow-up sessions.

• Monitoring & Sustainability: Tracking patient outcomes, readmission trends, and provider adherence.

Effective implementation requires interprofessional collaboration among nurses, physicians, dieticians, social workers, and patients, ensuring comprehensive care and sustainability (Quanbeck, 2019; Ten Ham-Baloyi, 2022).

Conclusion

HF remains one of the most challenging chronic diseases, both clinically and economically. Poor self-care and limited health literacy are key contributors to high readmission and mortality rates. Evidence strongly supports the integration of multimedia education, reflective learning, and teach-back methods to improve patient comprehension, reduce anxiety, and strengthen self-care.

References

Centers for Disease Control and Prevention. (2019). Hospitalization for congestive heart failure, United States. https://www.cdc.gov/nchs/products/databriefs/db108.htm

Centers for Disease Control and Prevention. (2020). Interactive atlas of heart disease and stroke. https://nccd.cdc.gov/DHDSPAtlas/reports.aspx

Centers for Disease Control and Prevention. (2022). Public health action plan to prevent heart disease and stroke. https://www.cdc.gov/dhdsp/action_plan/pdfs/action_plan_full.pdf

Centers for Disease Control and Prevention. (2023). Facts of heart failure in the United States. https://www.cdc.gov/heartdisease/heart_failure.htm

Ding, H., Jayasena, R., Chen, S., Maiorana, A., Dowling, A., Layland, J., Good, N., Karunanithi, M., & Edwards, I. (2020). The effects of telemonitoring on patient compliance with self-management recommendations and outcomes of the innovative telemonitoring enhanced care program for chronic heart failure: Randomized controlled trial. Journal of Medical Internet Research, 22(7), e17559. https://doi.org/10.2196/17559

Groenewegen, A., Rutten, F., Mosterd, A., & Hoes, A. (2020). Epidemiology of heart failure. European Journal of Heart Failure, 22(8), 1342–1356. https://doi.org/10.1002/ejhf.1858

Heidenreich, P. A., Fonarow, G. C., Opsha, Y., Sandhu, A. T., Sweitzer, N. K., Warraich, H. J., & HFSA Scientific Statement Committee Members. (2022). Economic issues in heart failure in the United States. Journal of Cardiac Failure, 28(3), 453–466. https://doi.org/10.1016/j.cardfail.2021.12.017

Lee, C., & Ho, K. (2019). Knowledge to action framework for home health monitoring. Healthcare Management Forum, 32(4), 183–187. https://doi.org/10.1177/0840470419855364

Mohammadi, F., Jahromi, M. S., & Bijani, M. (2021). Investigating the effect of multimedia education in combination with teach-back method on quality of life and cardiac anxiety in patients with heart failure: A randomized clinical trial. BMC Cardiovascular Disorders, 21(1), 535. https://doi.org/10.1186/s12872-021-02357-z

Mujib, M., Zhang, Y., Feller, M. A., & Ahmed, A. (2011). Evidence of a “heart failure belt” in the southeastern United States. The American Journal of Cardiology, 107(6), 935–937. https://doi.org/10.1016/j.amjcard.2010.11.012

Pereira Sousa, J., Neves, H., & Pais-Vieira, M. (2021). Does symptom recognition improve self-care in patients with heart failure? A pilot study randomized controlled trial. Nursing Reports, 11(2), 418–429. https://doi.org/10.3390/nursrep11020040

Piña, I. L., Allen, L. A., & Desai, N. R. (2021). Managing the economic challenges in the treatment of heart failure. BMC Cardiovascular Disorders, 21(1), 612. https://doi.org/10.1186/s12872-021-02408-5

Quanbeck, A. (2019). Using stakeholder values to promote the implementation of an evidence-based mobile health intervention for addiction treatment in primary care settings. JMIR mHealth and uHealth, 7(6), e13301. https://doi.org/10.2196/13301

Rahmani, A., Vahedian-Azimi, A., Sirati-Nir, M., Norouzadeh, R., Rozdar, H., & Sahebkar, A. (2020). The effect of the teach-back method on knowledge, performance, readmission, and quality of life in heart failure patients. Cardiology Research and Practice, 2020, 8897881. https://doi.org/10.1155/2020/8897881

Singh, R., Javed, Z., Yahya, T., Valero-Elizondo, J., Acquah, I., Hyder, A. A., Maqsood, M. H., Amin, Z., Al-Kindi, S., Cainzos-Achirica, M., & Nasir, K. (2021). Community and social context: An important social determinant of cardiovascular disease. Methodist DeBakey Cardiovascular Journal, 17(4), 15–27. https://doi.org/10.14797/mdcvj.846

Ten Ham-Baloyi, W. (2022). Assisting nurses with evidence-based practice: A case for the Knowledge-to-Action framework. Health SA Gesondheid, 27, 2118. https://doi.org/10.4102/hsag.v27i0.2118

Torres, C. P., Mendes, F. J., & Barbieri-Figueiredo, M. (2023). Use of “The Knowledge-to-Action Framework” for the implementation of evidence-based nursing in child and family care: Study protocol. PLOS ONE, 18(3), e0283656. https://doi.org/10.1371/journal.pone.0283656

World Health Organization. (2021). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Butler, J., Fonarow, G. C., Gheorghiade, M., & Yancy, C. W. (2020). Improving heart failure care: The role of multidisciplinary teams and evidence-based practices. JAMA Cardiology, 5(8), 917–918. https://doi.org/10.1001/jamacardio.2020.1476

NR 716 Week 4 Translation Science and Synthesis

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