NR451 Capstone Course

Course Project Milestone #1: PICOT & Literature Review Worksheet

Student Name: Susana Ortega Date: May 1, 2013 Instructor’s Name: Dr. Lisa Kauffman-Craig

PICOT Worksheet

Purpose: To identify a problem or concern in nursing that can be addressed with evidence-based practice and to define key terms for a literature search.

Research Question: How do patients with Congestive Heart Failure (CHF) benefit from education provided by home health care nurses in reducing hospital readmissions?

PICO(T) Elements:

  • P (Population): Patients with congestive heart failure (CHF)
  • I (Intervention): Education and monitoring provided by home health care nurses, focusing on recognizing symptoms of CHF before they lead to emergency room visits.
  • C (Comparison): Standard care without home health services, leading to higher rates of hospitalization.
  • O (Outcome): Reduced hospital readmissions within a 60-day period.
  • T (Timeframe): The effectiveness of the intervention will be evaluated within a 60-day period.

Search Techniques:

  1. Databases to Use:
    • Centers for Disease Control and Prevention (CDC)
    • National Institute of Health (NIH)
    • ProQuest
  2. Focusing the Search:
    • If initial results are unsatisfactory, refine the search by focusing specifically on CHF or home health services. Keywords might include “CHF,” “home health care,” “patient education,” and “hospital readmissions.”
  3. Refining Search Results:
    • Use Boolean operators such as “AND” to narrow the search (e.g., “CHF AND home health”).
    • Apply final limiters such as English language, peer-reviewed journals, and recent publications within the last 5-10 years.

Literature Review Worksheet

Purpose: To find evidence supporting the intervention that will improve patient outcomes, specifically reducing hospital readmissions for CHF patients through home health care.

Selected Articles and Summary:

  1. Centers for Disease Control and Prevention (CDC) (2012):
    • Not Peer Reviewed
    • Summary: This article highlights the role of home health care in reducing hospitalizations for CHF patients, emphasizing the importance of ongoing monitoring and education.
    • Type of Research: Qualitative research focused on behavior change and patient compliance.
    • Outcome: Demonstrates how home health care can help CHF patients manage their condition, reducing the need for hospital readmission.
  2. Fortinsky, R. H., Madigan, E. A., & Riggs, J. S. (2011):
    • Not Peer Reviewed
    • Summary: Investigates the benefits of educating CHF patients on self-management at home, showing how such education reduces hospital visits.
    • Type of Research: Quantitative research assessing the impact of patient education on quality of life and healthcare utilization.
    • Outcome: Highlights the positive impact of home health services on patient outcomes.
  3. Grant, R., Holbert, B., Kvedar, J., Lugn, N., & Myers, S. (2006):
    • Not Peer Reviewed
    • Summary: Examines the effectiveness of home-based telemonitoring for CHF patients, reducing the need for frequent hospital visits.
    • Type of Research: Qualitative research focusing on patient experiences with telemonitoring.
    • Outcome: Demonstrates that telemonitoring, alongside home health services, can reduce hospitalizations.
  4. Hines, P. A., Yu, K., & Randall, M. (2010):
    • Not Peer Reviewed
    • Summary: Discusses various strategies, including home health care, to prevent CHF readmissions.
    • Type of Research: Meta-analysis evaluating the overall effectiveness of home health care.
    • Outcome: Supports the integration of home health services to decrease readmissions.
  5. Morrissey, J. (2012):
    • Not Peer Reviewed
    • Summary: Details a telemonitoring project aimed at CHF patients, highlighting its benefits and the continued need for in-person home health visits.
    • Type of Research: Quantitative research demonstrating the quality of life improvements through telemonitoring.
    • Outcome: Emphasizes the importance of both telemonitoring and direct nurse involvement.
  6. U.S. Department of Health and Human Services (2013):
    • Not Peer Reviewed
    • Summary: Discusses the development of electronic tools to improve transitions to home health care, reducing service costs and improving care coordination.
    • Type of Research: Systematic review analyzing the impact of electronic tools on patient care.
    • Outcome: Highlights the benefits of electronic tools in improving the coordination and quality of home health care.