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OPTIMIZING INPATIENT HEART FAILURE EDUCATION TO SUPPORT SELF-CARE AFTER DISCHARGE: A Case Study

A Capstone Project Proposal

STUDENT NAME: Maryanne Crowther
STUDENT NUMBER:XXXXXXXXX
DEPARTMENT:Doctor of Nursing Practice
Content:Capstone Proposal

Advisor/Mentor:Cheryl Holly, EdD
Amy Sirkn, DNP

DATE OF SUBMISSION: June 6, 2010
CONTENTS
ABSTRACT3
introduction/Background5
problem7
Existing Program7
The Innovation............................................................................................................................................................. 9 Inquiry Question17

OBJECTIVES AND AIMS17
Overall Objective179
Specific Aims17
Review of the Literature18
THEORETICAL MODEL............................................................................................................................................ 23 Project design and methods25
Design25
Setting26
Study Participants.................................................................................................................................................... 27 Sources of Data28
Data Analysis28
Ethics and Human Subjects Issues29
Timeframes29
Strengths and Weaknesses of the Study30
Health Disparities or Cultural Competence Significance31
references32
Appendices38
Appendix 1:41
Appendix 2:39
Appendix 3:41
Appendix 4:42
APPENDIX 5.............................................................................................................................................................. 43 APPENDIX 6 .................................................................................................................................................................44

ABSTRACT

Background: Heart Failure is the only cardiovascular disease that is increasing in prevalence and incidence. The syndrome accounts for recurrent illness, hospital readmissions and reduced health related quality of life. It is a top adult diagnosis in hospitals across the nation, with related adverse financial consequences to the patient, families, facilities and society overall. The Heart Failure Center Program at St. Joseph’s Regional Medical Center in Paterson, New Jersey, was instituted in 2005 to bring specialized care and attention to those hospitalized with heart failure. A recent project to achieve The Joint Commission Advanced Heart Failure Disease Specific Certification has highlighted the realization that more was needed to be done in order to attain superior quality in educating hospitalized heart failure patients. A new process was developed and implemented to standardize and optimize the amount of inpatient heart failure education disseminated to patients in an effort to support heart failure self-care after discharge.

Methods: This descriptive case study will reveal how, through a variety of methods, strategies were planned, implemented and evaluated to achieve success. Research questions guiding the study are based on Roger’s model of Diffusion of Innovations (2003) and include: 1. What are the patterns of diffusion for this project related to new HF patient education processes? 2. What were barriers to implementation of this project, and were they and how were they overcome? 3. What were facilitators for implementation of this project? 4. What were differences between units of analysis in diffusion of this innovation? 5. What recommendations can be made to support transferability? These questions are directed by study propositions that define the boundaries of the case. Units of analysis are embedded into the case study for investigation. Data are collected in ways that strengthen the case study and are linked to propositions. Analysis of data includes addressing rival explanations for findings.

Results: This case study will demonstrate how new and improved nurse-led interdisciplinary care processes for patients are...
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