Clinical Practice Development for Early Hospital Management of Acute Heart Failure

Running head: CLINICAL PRACTICE DEVELOPMENT
CLINICAL PRACTICE DEVELOPMENT
Name of the Student
Name of the University
Author note

1CLINICAL PRACTICE DEVELOPMENT
Introduction
The primary aim of this paper is to identify the early hospital management strategies for
individual aged 50 and above so that the risk of congestive heart failure could be understood who
are admitted in the X healthcare facility. Further, using this diagnosis, the paper will develop a
clinical audit plan so that the above mentioned literatures could be used to manage the patient
conditions admitted in the healthcare facilities for early care management (Numan et al., 2012).
This paper will be divided into two parts, in which the part A will contain the rationale to the
topic and its importance in current settings, Further, a clinical audit related question will be
developed which will be followed by a PICO question so that the research could be directed
towards a specific direction (Myhill, Booth & McLaren-Howard, 2013). A specific search
strategy will be used to search and identify relevant research literatures and after that the
research findings will be rated against the Joana Briggs level of evidence so that the actual
meaning and effectiveness of the situation can be understood. This portion will further include
the clinical bottom line as a summary and critique to the evidence collected from the search
strategy and as per this, the standard of best practices will be presented and graded in the
assignment properly.
Background and rationale
Acute heart failure is the condition in which, the healthcare physicians, nursing
professionals, intensivists, cardiologists and other healthcare professionals have to work in
coordination so that the patient could be helped with a rapid intervention. It requires a rapid
assessment of the situation as in such health condition, healthcare professionals need to take
treatment decisions depending on expert consensus rather that any available evidence

2CLINICAL PRACTICE DEVELOPMENT
(Authors/Task Force Members, McMurray et al., 2012). Therefore, it is important for the
healthcare professionals to be aware of the healthcare management strategies which should be
implemented after the hospitalization of individual affected with acute heart failure. Further the
importance of these strategies increases with the increasing age of patients affected with acute
heart failure as people above the age of 50 years are prone to be affected with congestive heart
failure and hence, they require proper preventive and management strategies so that appropriate
care can be implemented (Teerlink et al., 2013).
The importance of healthcare interventions and nursing professionals cannot be denied in
this scenario. Observational reassessment is conducted so that mental and physical concerns of
the patients can be addressed and therefore the healthcare interventions should be able to change
the clinical status of the care process. As mentioned by Ponikowski et al. (2016), all the
healthcare professionals and nursing professionals should be aware of the early healthcare
interventions for patients affected with acute heart failure so that their heart congestions can be
treated properly within time.
Application of PICO format
PICO format is used in clinical audit scenario to identify the audit question and its
associated population, intervention, identified problem and its expected outcomes. This helps to
direct the research in correct direction with proper data base search.
Population/problem Individuals identified with acute heart failure
aged 50 or above and who are having high
risk of congestive heart failure in the absence
of early healthcare management. Therefore,
the multidisciplinary team should be able to
take proper decision regarding the healthcare

3CLINICAL PRACTICE DEVELOPMENT
management of people affected with acute
heart failure so that their physical and
psychological wellbeing can be maintained.
Intervention Early healthcare management will be used as
an important intervention in the early and
primary stage of congestive heart failure so
that with usage of early intervention patient’s
condition can be treated.
Comparison This intervention will be compared with the
multidisciplinary team and their interventions
so that effectiveness of both can be
calculated.
Outcomes The acute heart failure and related congestive
heart condition will be controlled and the
patient condition could be improved.
Clinical audit question
The clinical audit question for this assessment will be regarding the compliance of the
healthcare facilities members and its multi-disciplinary teams regarding the acute heart failure
and associated early healthcare interventions. This is important to find out as it helps in the
surgical risk reducing strategies for people aged over 50 years who are suffering from acute heart
failure and has increased risk of congestive heart failure.
Search strategy and findings
For this assessment different online databases were assessed and from those databases
such as PubMed, google scholar, Cochrane and CINAHL a set of different terminologies, with
proper combinations were searched and from those papers related to acute heart failure and early
healthcare inventions as a preventive and effective measure were selected. a total of 23 papers
were found that matched the inclusion criteria, however depending on the sample size,
interventions used and the data collection and interpretation techniques, 4 papers were selected

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for critical discussion in this assignment. The details of the search strategy and findings are
mentioned in the table below:
Electronic databases
MEDLINE
CINAHL
Cochrane
PubMed
Google scholar
Joanna-Briggs Institute
Keywords
Acute heart failure
Heart failure
Cute failure of the heart
Congestive heart failure
Increasing risk of congestive
heart failure
Enhanced risk related to
congestive heart failure
Congestive heart failure due to
acute heart failure
Using early healthcare
interventions to control acute
heart failure so that patient
condition can be improved
Early hospital management in
acute heart failure
Inclusion criteria Exclusion criteria
English language
Individual with age 50 and above
Studies conducted on humans
Languages other than English
Studies conducted on non-human samples,
and on individuals below the age 50
After collecting data from research articles, the level of evidence found in research were
rated as per the Joanna-Briggs level of evidence for effectiveness and meaningful research.
Ratings Levels Evidences Number of
studies
Studies
Highest Level 1 Qualitative or
mixed methods
systematic
review

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Level 2 Qualitative or
mixed methods
synthesis
Level 3 Single
qualitative study
Level 4 Systematic
review of expert
opinion
1 (Mebazaa et al.,
2015)
Lowest Level 5 Expert opinion 2 (Authors/Task
Force Members
et al., 2012),
(Amsterdam et
al., 2014)
Total 3
Part B
Critique to the clinical audit related topic
It is evident from research articles and healthcare experts opinion that acute heart failure
is a condition to combat which, complete attention and efficiency of healthcare professionals,
physicians, cardiologists and intensivists and other professionals are required so that early
hospital management could help in maintaining patients stability and improving health condition
(Abraham et al., 2015). There are several guidelines, using which healthcare professionals can
manage the health condition of patients in pre hospital or in hospital settings. These guidelines
help in filling out the gaps present in the care process so that management of acute heart failure
becomes controllable and easy to handle. One such strategy has been mentioned in the research
paper of Mebazaa et al. (2013), in which the researchers mention the use of GDMT or the
Guideline Directed medical Therapy in which the lifestyle related choices of patients are merged
with the drug and device based therapies so that a holistic and approachable care could be