NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers (1)

PICOT Question

Sharing evidence-based practice results on lowering readmissions related to heart failure was done using the PICO(T) framework. Initially, the target population for the intervention was identified as individuals with heart failure. The intervention modality that will be utilized is telehealth. Data will be collected for a year in order to compare the chosen intervention to standard care. A PICO(T)-question was used to investigate: What is the impact of starting telehealth sessions on the number of readmissions to the hospital within a year with respect to standard care for patients with heart failure?

Sources Used

One of the sources included in NURS FPX 4025 Assessment 4 was a systematic review of RCTs that examined the use of remote monitoring to lower the readmission rates of patients with chronic bronchitis and heart failure (Stergiopoulos et al., 2024). According to Stergiopoulos et al. (2024), the telemonitoring measures included remote readings of blood pressure, weight, heart rate, and oxygen saturation. When presenting nursing research findings, it is crucial to note that 67% of the RCTs analyzed by Stergiopoulos and colleagues showed no discernible impact of telemonitoring on the readmission of patients with heart failure (Stergiopoulos et al., 2024). Frontiers in Digital Health is an interdisciplinary, peer-reviewed journal that published this research in 2024. It is accessible through PubMed Central and is crucial for sharing evidence-based practice results. Since the writers are physicians affiliated with Johns Hopkins or the Mayo Clinic, they are reliable sources in the medical community. Since the proposed PICO(T) question focuses on the issue of telemedicine’s potential to reduce readmissions among heart failure patients, the research topic of the conducted systematic review, as covered in NURS FPX 4025 Assessment 4, closely relates to the patient population, outcome, and intervention.

The requirement to define the impact of mobile health applications on improving outcomes for patients with heart failure was the focus of a systematic review and meta-analysis that was also selected as an additional source of evidence (Ni et al., 2024). In this review, one of the outcomes that was considered was hospitalization rates. The components of the mobile app in NURS FPX 4025 Assessment 4 included telehealth visits, social support access, educational resources, patient-specific advice, reminders, and the ability to record reported symptoms and vital signs (Ni et al., 2024). According to the study’s findings, sharing evidence-based practice shows that the adoption of mobile applications boosts patient-provider communication and patient self-disease management. This lowers hospitalization rates and improves the quality of life for patients with heart failure (Ni et al., 2024). Peer-reviewed journals like the Journal of Nursing Management published the work in 2024. The CINAHL Complete database assists in identifying it. West China Hospital’s Department of Cardiology is where Ni and the other authors work. Ramtin and colleagues’ (2023) systematic review and meta-analysis study was the other piece of evidence found. It aimed to determine whether the use of remote education PoC had any impact on heart failure patients’ readmission rates. According to Ramtin et al. (2023), remote education will be defined as instruction delivered by phone or video conversations, text messages, telemonitoring, individual education, mobile applications, and booklets (the latter in hard copy) in the framework of NURS FPX 4025 Assessment 4. According to the authors’ findings from this systematic review and meta-analysis, telemedicine and other forms of distance learning may assist in lower readmission rates for patients with heart failure (Ramtin et al., 2023). Through the ProQuest Nursing Databases, this study was discovered. An open-access journal published by John Wiley & Sons, Inc., published the study first in The Nursing Open, a peer-reviewed

publication. Also, the study was published in 2023 and focuses on readmission rates in heart failure patients, which makes it relevant to the current diagnostic and research topic.

Evidence Analysis

A solid foundation for answering the stated PICO(T) question is provided by the reviewed evidence: How does the introduction of telehealth visits to patients with heart failure affect the incidence of readmissions to hospitals over a year when compared to standard care? One source of evidence indicates that the use of telehealth telemonitoring was not statistically significant in lowering rehospitalization rates among patients with heart failure (Stergiopoulos et al., 2024). Presenting nursing research findings from other studies has suggested that different forms of telehealth treatments could be useful in lowering admission rates, even though the findings on the significance of telemonitoring for readmission rates were statistically irrelevant. The significance of sharing evidence-based practice results is highlighted by Ni and colleagues’ (2024) systematic review and meta-analysis. It found that the mHealth application, a technology that allows patients to monitor their symptoms, enter self-reported vital signs, participate in telehealth visits with HF healthcare providers, and access educational material, showed a reduced hospitalization incidence overall in their HF patient population. Distance learning has proved helpful in lowering readmission rates among HF patients, according to the findings of another systematic review and meta-analysis conducted by Ramtin and colleagues in 2023. The study by Ni and colleagues (2024) confirms the findings of Ramtin and colleagues (2023), who found that the availability of telehealth phone calls and video visits reduced the rate of readmissions among patients with heart failure. When compared to the situation in which telehealth modalities are not used, it may be inferred that telehealth has the potential to be beneficial in reducing hospital readmission rates. Telemonitoring was found to have lost its

significance in general (Stergiopoulos et al., 2024). Nevertheless, as mentioned in NURS FPX 4025 Assessment 4, remote learning resources and mobile health application usage can also help to reduce the total number of readmissions in patients with the HF condition (Ni et al., 2024; Ramtin et al., 2023).

Key Steps of Care

The information gathered suggests that interventions within care can be made to reduce hospitalizations for heart failure in the future, highlighting the need to communicate research outcomes in healthcare. One of the crucial steps is to guide the launch of mobile health applications. According to Ni et al. (2024), mobile health applications can help patients self-report and track their symptoms, access telehealth educational and social support services, and receive personalized treatment recommendations. Because the apps can provide real-time information, providers can profit from earlier actions and, in certain situations, avoid hospitalization. Providing additional options for patients to receive education remotely is the next important step that may be taken. It is possible to provide access to learning materials and online courses through telephone and online video calls with clinicians (Ramtin et al.,2023). Reduced readmission rates among heart failure patients can alleviate the pressure on both the patient and the healthcare system overall by using the techniques discussed in NURS FPX 4025 Assessment 4.

References

American Heart Association (AHA). (2023, March). What is heart failure? heart.org. Retrieved March 20, 2025, from https://www.heart.org/en/health-topics/heart-failure/what-is-heart- failure

Bozkurt, B., Ahmad, T., Alexander, K. M., Baker, W. L., Bosak, K., Breathett, K., Fonarow, G. C., Heidenreich, P., Ho, J. E., Hsich, E., Ibrahim, N. E., Jones, L. M., Khan, S. S., Khazanie, P., Koelling, T., Krumholz, H. M., Khush, K. K., Lee, C., Morris, A. A., Page, R. L., 2nd, … Writing Committee Members (2023). Heart Failure Epidemiology and Outcomes Statistics: A Report of the Heart Failure Society of America. Journal of cardiac failure, 29(10), 1412–1451. https://doiorg.library.capella.edu/10.1016/j.cardfail.2023.07.006

Malik A, Chhabra L. (2023). Congestive heart failure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. https://www.ncbi.nlm.nih.gov/books/NBK430873/

Ni, Y.-X., Liu, X.-H., He, L., Wen, Y., You, G.-Y., & Igarashi, Y. (2024). Mobile Application‐ Based Interventions for People with Heart Failure: A Systematic Review and Meta‐ Analysis. Journal of Nursing Management, 2024, 1–14. https://doiorg.library.capella.edu/10.1155/2024/6859795

Oskouie, S., Pandey, A., Sauer, A. J., Greene, S. J., Mullens, W., Khan, M. S., Quinn, K. L., Ho, J. E., Albert, N. M., & Van Spall, H. G. (2024). From Hospital to Home: Evidence-Based Care for Worsening Heart Failure. JACC. Advances, 3(9), 101131. https://doi- org.library.capella.edu/10.1016/j.jacadv.2024.101131

Roger, V. L., & Clinic, M. (2021). Epidemiology of heart failure. Circulation Research, 128(10), 1421. https://10.1161/circresaha.121.318172

Stergiopoulos, G. M., Elayadi, A. N., Chen, E. S., & Galiatsatos, P. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in digital health, 6, 1441334. https://doi-org.library.capella.edu/10.3389/fdgth.2024.1441334