* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Running head: PROFESSIONAL ACTION PLAN FOR ISCHEMIC
Survey
Document related concepts
Cardiac contractility modulation wikipedia , lookup
Baker Heart and Diabetes Institute wikipedia , lookup
Heart failure wikipedia , lookup
Electrocardiography wikipedia , lookup
Management of acute coronary syndrome wikipedia , lookup
Saturated fat and cardiovascular disease wikipedia , lookup
Rheumatic fever wikipedia , lookup
Cardiovascular disease wikipedia , lookup
Remote ischemic conditioning wikipedia , lookup
Dextro-Transposition of the great arteries wikipedia , lookup
Transcript
Running head: PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION Professional Action Plan for Ischemic Heart Condition Disease [Student’s Name] [Institutional Affiliation] 1 PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 2 Professional Action Plan for Ischemic Heart Condition Disease Introduction Ischemic heart Disease also abbreviated as IBD refers to a condition in which the heart muscles receive reduced supply of blood (Gibson, Shah & Umberger, 2014 359). Consequently, IHD causes a discrepancy between the oxygen and supply and demand. IHD reflects a manifestation of atherosclerosis of the coronary artery that can happen gradually or faster leading to their blockage (Lilly, 2011). Ischemic heart disease has claimed and continues to be a major cause of deaths in the industrialized nations such as America (Gibson, Shah & Umberger, 2014 359). The accumulation of cholesterol particles that are transported through blood in the arteries lead to their corresponding accumulation on the arterial walls that innervate the heart (coronary artery). These deposits may accumulate to levels that they form plaques that eventually narrow the arteries causing reduced flow of blood (Lilly, 2011). Consequently, oxygen supply to the heart muscles is reduced a great deal. It is noteworthy that ischemic heart disease is sometimes referred to as coronary heart disease a term that is widely used in literature in place of the ICD (Gibson, Shah & Umberger, 2014 359). The signs and symptoms of ischemic heart disease conditions may show up either gradually after or immediately the artery gets blocked. One of the most common symptoms of IHD is angina pectoris or as it is famous angina which is a hallmark symptom of IHD (WHO, 2007). Angina is a medical term that is used to refer to significant pain and discomfort in the chest due to decreased supply of oxygen to the heart (Lilly, 2011). Stable angina occurs when an individual suffering from IHD exercises and comes through pain episodes that are predictable and can be relieved by a deep and long rest (Gibson, Shah & Umberger, 2014 359). On the other [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 3 hand, unstable angina occurs only at rest and occurs due to reduced response to treatments and is unpredictable. Variant angina is also another symptom that comes as pain caused by the spasms in the coronary artery and is not predictable neither is it stress-induced (Bradshaw, Alfonso, Finn, Owen & Thompson, 2009). The good thing with ischemic heart disease, is that it can be treated through medications and alteration of lifestyles (National Heart Foundation of Australia, 2015). This paper presents the issue of ischemic heart disease in the aboriginal population of Australia and comes up with a professional action plan for the ischemic heart disease conditions on the chosen Aboriginal population. Additionally, this paper also presents strategies that will be used to fulfil the objectives and aims of the proposed professional action plan including their strengths and drawbacks. Population and Setting The Noongar, Nyugar, Nyungah, Noonga or Nyoongar are indigenous Australian people who inhabit the southern of Western Australia (Dana & Anderson, 2007, 514). The Noongar country is occupied by 14 distinct groups that make part of the aboriginal population. These people inhabit the Mediterranean climate lands and engage in different activities such as, agriculture, hunting and gathering, to support their lifestyles (Dana & Anderson, 2007, 514). With the setting of the contemporary Australian society, the Noongar people have had lost generation and are currently faced with issues such as nutrition and diet among others that have health, psychological and social importance (Dana & Anderson, 2007, 514). The indigenous people in general and so the Noongar population, have been the center of research for most of the chronic conditions both preventable and curable as well as non-curable chronic diseases (Dana & Anderson, 2007, 514). Basing this action plan on the Noongar people will be beneficial and [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 4 timely since it is the time when health issues of the indigenous people are being explored. Some of the risk factors among the Noongpar people include smoking, obesity and diabetes that elevate the levels of coronary heart disease (Dana & Anderson, 2007, 514). Aim The major aim of this professional action plan is to prevent, manage and rehabilitate ischemic heart condition to meet the needs of the Noongar population of southern of WestAustralia. Smart Objectives To reduce the number of deaths, through preventing Ischemic heart disease conditions, among the Noongar people by half the current rate in the next three years that is by 2019. To effectively manage Ischemic heart disease prevalence and incidence among the Noongpar people by 2018. To rehabilitate the Noongar people who have Ischemic heart disease conditions by 2018. Strategies Secondary Ischemic Heart Disease Prevention Strategies The first strategy under secondary prevention of CHD is education of the Patients on the cardiovascular risk factors and their reduction strategies, importance of adhering to medication, some self-monitoring skills, and lifestyle management elements that have an impact on prognosis (National Heart Foundation of Australia, 2015). First off, the IHD patients must be educated on how to increase their healthiness and promote individual wellness (Delgado, 2009). This can be done through scheduled group meetings with the whole group of identified IHD patients. The patients can also be taught the importance of adhering to medication and the impacts of not observing that to their prognosis. [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 5 The population should also be introduced to a comprehensive review that covers the available options for the medication as well as the risk factors and the self-monitoring skills. The population should also be taught on the symptoms of worsening CHD or IHD so that they are able to take the right course of action (Delgado, 2009). The population should also be taught about the need, appropriate levels and the best plans for physical activity (Boudi & Ahsan, 2015; National Heart Foundation of Australia, 2015). In the education program, the whole population from which the patients hail from can be accessed in order to promote awareness that will prevent further increase in CHD among the population members. Some of the outcome measures is the decreased rate of mortality and comorbidity among the population. The whole population should also be educated on the risk factor modification options that are available (National Heart Foundation of Australia, 2015). This will majorly cover the lifestyle changing options among the Noongar population. First off, they will be taken through the methods and benefits used in control of weight and maintenance of a good body-mass index (BMI). In this case, the recommended BMI will be 18.5-24.9 kg/m2 (Boudi & Ahsan, 2015). Additionally, the population should also be taught on how to maintain a waist circumference of 30 inches for the females and 40 inches for men (National Heart Foundation of Australia, 2015). The other important education that the Noongar people will be taken through is lipid management methods, how to control their blood pressure, and the importance of ceasing smoking and alcohol (National Heart Foundation of Australia, 2015). Additionally, for the patients diagnosed with diabetes mellitus after screening will be taken through an individualized medical, dietary, and lifestyle management education. Risk Factor Modification [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 6 Encouraging the patients to adopt healthy eating lifestyles through inclusion of plant based meals and foods in their diet (National Heart Foundation of Australia, 2015). The foods include fruits, vegetables and whole grains. The patients and the whole population should be encouraged to reduce consumption of high fat dairy products, unprocessed poultry, fish and meat (Fihn et al., 2012). The population should also be encouraged to reduce salt intake and avoid saturated fatty acid and trans-fatty acid (Fihn et al., 2012). The population after being evaluated for smoking should be encouraged to stop smoking as well as avoid secondary smoke from smokers (Fihn et al., 2012). The smokers can be given smoking cessation therapy or enrolled in smoking cessation program as well as pharmacotherapy for the patients who still smoke (Qaseem, 2012). The population that smokes will be introduced to the stepwise smoking cessation strategy that involves asking, advising, assessing, assisting and arranging (Boudi & Ahsan, 2015). The next phase would be mandatory and scheduled strict follow-up (National Heart Foundation of Australia, 2015; WHO, 2007). For weight loss the patients and the whole population in general will be advised on how to observe their caloric intake, conduct structured 150 minutes exercises per week and general behavioural programs and practices that will reduce keep check of BMI and weight (Boudi & Ahsan, 2015). The population and the patients will be taken through some basic exercises (Qaseem, 2012). However, initially there must be a mandatory exercise test to asses and therefore group the patients and the other population that is not suffering (National Heart Foundation of Australia, 2015). The patients should be encouraged to walk at least five days a week and have physical exercises of about 30 minutes such as jogging, walking, hitting the gym, gardening and doing household chores (National Heart Foundation of Australia, 2015; WHO, 2007). There will [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 7 also be the inclusion of home-based programs for the high-risk patients drawn from the population. Ischemic Heart Disease Management Strategies There are two major management strategies for IHD that is medical and pharmacological management. Medical management involves various therapies that target and thus reduce lipids such as satin. The satin therapy should be started for the Noongar patients who have been hospitalized after the assessment and diagnosis phases (Boudi & Ahsan, 2015). The patients should be made to understand the benefit of satin as a medical intervention that will enrich their lives (National Heart Foundation of Australia, 2015). Moreover, the patients should be emancipated about the importance of engaging in lifestyle changes despite taking satin doses. For the overweight patients they should be given Fibrates to reduce their cardiovascular risks especially when diagnosed with type 2 diabetes (Fihn et al., 2012; Qaseem, 2012). Ezetimibe can also be administered to the patients to reduce the concentration levels of LDL-C either independently or alongside satin therapy (Boudi & Ahsan, 2015). The patients diagnosed with hypotension should be advised on the need for managing their weight, avoiding alcohol and high salt intake (Boudi & Ahsan, 2015). In adverse cases of hypotension then combination of drugs can be used to manage the situation (Lavie & Milani, 2011). Vitamin C, E and beta carotene supplements may also be administered to reduce the risks among the IHD patients (Boudi & Ahsan, 2015). All the patients from the population that have been diagnosed with IHD should receive jabs of influenza and pneumococcal vaccinations on an annual basis unless there are contraindications (National Heart Foundation of Australia, 2015; WHO, 2007). Ischemic Heart Disease Rehabilitation strategies [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 8 There are very many rehabilitation options or strategies that are available for IHD/CHD. First step involves counselling the patients with comorbid depression using various channels such as medical and peer counsellors (Lavie & Milani, 2011). This should be followed by a depression medical management program. Patients with decreased adherence to medicine should be encouraged to adhere to the medications for better health (Fihn et al., 2012). There should be the inclusion of interpersonal psychotherapies and cognitive based behavioural therapies to counter the effects of depression among the patients. Antidepressants such as serotonin reuptake inhibitor can also be used (Leon, 2005). The patients should also be given social support from the local specialists such as physicians, social workers and cardiac rehabilitation organizations as well as psychologist when diagnosed with depression (Lavie & Milani, 2011; Qaseem, 2012). Such organizations include the Heart Support Australia and the Heart Foundation Walking Groups (Leon, 2005). Cardiac rehabilitation strategies through education and exercises under the direction of physicians is also beneficial for rehabilitation of IHD (Fihn et al., 2012; National Heart Foundation of Australia, 2015). The patients should be engaged in timed physical exercises, taken through the process of understanding the need to change lifestyle, made to embrace chores that increase physical activity and taught on the best diets to make them active and free from any heart conditions risk factors (Lavie & Milani, 2011; Leon, 2005). Actions, Outcome Measures, Outcome Indicators, by whom? And Timeline Outcome Measures Registers of inpatients and outpatients of Noongar suffering from IHD in West Australian Hospitals. [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION Surveys on the number of people who have ceased smoking and are actively engaging in exercises. Attendance list of the education sessions among the Noongpar people. Questionnaires and interviews on the quality of life and progress from the time of intervention (Fihn et al., 2012). Death registrar and reports on the Noongar who die from IHD. Patient follow-ups. Assessment of the frequency and adequacy of the intervention programs. Surveillance of complications from IHD and associated disease. Outcome Indicators Long-term care Mortality Morbidity Quality of life Complications of IHD among infants Premature death due to IHD Emergency department visits Hospitalizations Invasive procedures (Fihn et al., 2012). By Whom? The intervention strategies are meant to be implemented by the General practitioners, Nurses, Social workers, Cardiologists, radiology units, physician assistants, nutritionists and [Student Name] [Student Number] 9 PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 10 dieticians, and Advanced Practice Nurses (Fihn et al., 2012; National Heart Foundation of Australia, 2015). Strengths and Drawbacks Prevention, management and rehabilitation of cardiovascular heart disease or IHD among the Noongar people including the infants (Qaseem, 2012). Restoration of the quality of life of the Noongar population through reducing the costs associated with treatment of IHD (Qaseem, 2012). Drawbacks Costs associated with the whole action implementation process (Qaseem, 2012). Some of the medications for cessation of smoking might worsen the situation further leading to high suicide attempts due to varenicline (Qaseem, 2012). False negative results of older and aged population due to high prevalence of IHD (Qaseem, 2012). The participation of the community is also not assured. [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 11 Professional Action Plan Aim: The major aim of this professional action plan is to prevent, manage and rehabilitate ischemic heart condition to meet the needs of the Noongar population of southern of WestAustralia. Objective Strateg Actions Outcomes Outcome By who? Timelin y Measures Indicator e s To reduce Seconda Education Surveillance of Long-term Nurses. End of the number ry Programs the symptoms. care Physicians. 2018 of deaths, Preventi and Hospitalization Mortality Advanced through on Training s. Morbidity Practice preventing strategie sessions. Patient follow- Quality of Nurses. Ischemic s for Outreach up. life Communit heart disease Ischemi and Registers of Complicat y Based conditions, c Heart Emancipatio inpatients and ions of Health among the Disease n programs. outpatients of IHD Organizati Noongar Conditio Smoke Noongar among ons. people by ns. Cessation suffering from infants Health half the programs. IHD in West Premature Institutions current rate Australian death due and in the next Hospitals. to IHD Ministry of three years Surveys on the Emergenc Health. that is by number of y 2019. people who departmen have ceased t visits smoking and Hospitaliz are actively ations engaging in Invasive exercises. procedure Surveillance of s complications from IHD and associated disease. [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION To effectivel y manage Ischemic heart disease prevalenc e and incidence among the Noongpa r people by 2018. Ischemi c Heart Disease Manage ment Strategie s. Medical Intervention s. Pharmacolo gical Intervention s. To rehabilitate the Noongar people who have Ischemic heart disease conditions by 2018. Ischemi c Heart Disease Rehabili tation strategie s Psychologic al Managemen t. Cardiac rehabilitatio n. Counselling Medical intervention s [Student Name] [Student Number] Death registrar and reports on the Noongar who die from IHD. Questionnaires and interviews on the quality of life and progress from the time of intervention. Registers of inpatients and outpatients of Noongar suffering from IHD in West Australian Hospitals Surveillance of complications from IHD and associated disease. Questionnaires and interviews on the quality of life and progress from the time of intervention. Registers of inpatients and outpatients of Noongar suffering from IHD in West Australian Hospitals. Surveillance of complications from IHD and associated disease. 12 Quality of life Complicat ions of IHD among infants Premature death due to IHD Emergenc y departmen t visits Hospitaliz ations Invasive procedure s Nurses. Physicians. Advanced Practice Nurses. Communit y Based Health Organizati ons. Health Institutions and Ministry of Health. End of 2018 Quality of life of the Patients Depressio n levels among the Patients Complicat ions of IHD among infants Premature death due to IHD Emergenc y departmen t readmissio ns Psychologi End of sts. 2018 General Practitioner s. APNs. NGOs. Social Workers. PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 13 Conclusion This professional action plan is based on ischemic heart disease condition that is one of the chronic diseases that affects different populations. The action plan proposes three strategies that will be used in management, prevention and rehabilitation of patients with ischemic heart disease conditions among the Noongar people of Western Australia. There are various stakeholders that can use the information of this action plan. First off, the nurses and medical practitioners can apply this action plan to mitigate the IHD among the Noongar people. Secondly, the ministry of health can apply the action plan when coming up with policies and funding various programs for the Noongar people. Lastly, the non-governmental organizations can also use the action plan to respond to the challenges that are facing the Noongar with respect to ischemic heart disease. Since Ischemic heart disease is widespread all over the world, this action plan is adaptable to nearly all the populations in different countries. [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 14 References Boudi, B., & Ahsan, C. (2015). Coronary Artery Atherosclerosis Treatment & Management: Approach Considerations, Preventive Strategies, Treatment of Low HDL levels and High Triglyceride levels in Patients With Diabetes. Emedicine.medscape.com. Retrieved 24 October 2015, from http://emedicine.medscape.com/article/153647-treatment Bradshaw, P., Alfonso, H., Finn, J., Owen, J., & Thompson, P. (2009). Measuring the gap: accuracy of the Western Australian hospital morbidity data in the identification of adult urban Aboriginal and Torres Strait Islander people. Australian and New Zealand Journal of Public Health, 33(3), 276-279. http://dx.doi.org/10.1111/j.1753-6405.2009.00388.x Dana, L., & Anderson, R. (2007). International handbook of research on indigenous entrepreneurship. Cheltenham: Edward Elgar. Delgado, R. (2009). Interventional treatment of advanced ischemic heart disease. London: Springer. Fihn, S., Gardin, J., Abrams, J., Berra, K., Blankenship, J., & Dallas, A. et al. (2012). 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation, 126(25), e354-e471. http://dx.doi.org/10.1161/cir.0b013e318277d6a0 Gibson, J., Shah, B., & Umberger, R. (2014). Clinical medical assisting. Burlington, MA: Jones & Bartlett Learning. Lavie, C., & Milani, R. (2011). Cardiac Rehabilitation and Exercise Training in Secondary Coronary Heart Disease Prevention. Progress in Cardiovascular Diseases, 53(6), 397-403. http://dx.doi.org/10.1016/j.pcad.2011.02.008 Leon, A. (2005). Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease: An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 111(3), 369-376. http://dx.doi.org/10.1161/01.cir.0000151788.08740.5c Lilly, L. (2011). Pathophysiology of heart disease. Baltimore, MD: Wolters Kluwer/Lippincott Williams & Wilkins. National Heart Foundation of Australia. (2015). Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease (1st ed., pp. 1-20). Melbourne: National Heart Foundation of Australia. Retrieved from http://www.heartfoundation.org.au/SiteCollectionDocuments/Reducing-risk-in-heartdisease.pdf [Student Name] [Student Number] PROFESSIONAL ACTION PLAN FOR ISCHEMIC HEART DISEASE CONDITION 15 Qaseem, A. (2012). Management of Stable Ischemic Heart Disease: Summary of a Clinical Practice Guideline From the American College of Physicians/American College of Cardiology Foundation/American Heart Association/American Association for Thoracic Surgery/Preventive Cardiovascular Nurses Association/Society of Thoracic Surgeons. Annals of Internal Medicine, 157(10), 735. http://dx.doi.org/10.7326/0003-4819157-10-201211200-00011 WHO. (2007). Prevention of Cardiovascular Disease: Guidelines for assessment and management of cardiovascular risk (1st ed., pp. 1-85). Avenue Appia: Geneva: World Health Organization. Retrieved from http://www.who.int/cardiovascular_diseases/guidelines/Full%20text.pdf [Student Name] [Student Number]