The Cardiovascular Screening For Women Assignment Paper

This paper is a continuation of another paper. I will provide the first half, as well. The instructions say 10-15 pages, but I have completed eight already. I am asking for three pages to meet the requirements. Also, the population is underserved can you incorporate the importance of this study to this population in conclusion?

Cardiovascular diseases affect the heart muscles and the blood vessels. They include coronary artery disease, peripheral artery disease, aortic atherosclerosis, and cerebrovascular disease. The causes of cardiovascular diseases are embolism, atrial fibrillations and rheumatic fever (Woodward, M. 2019). The risk factors are physical inactivity, a high-calorie diet, saturated fats, sugars, and metabolic syndrome. Cardiovascular diseases are common in women, people of low socioeconomic status, patients on other medication, psychiatric disorders, the elderly, and ethnic minorities. The modifiable risk factors in these groups are hypertension, diabetes mellitus, hyperlipidemia, obesity, smoking, and a sedentary lifestyle (Zambrano et al., 2020)The Cardiovascular Screening For Women Assignment Paper. The non-modifiable risk factors are family history of heart disease, age, and gender.

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Cardiovascular Diseases In Women

Screening of cardiovascular diseases is essential in early diagnosis and treatment to prevent mortalities. Cardiovascular diseases are the leading cause of death in women globally. More than 3 million women are diagnosed with heart disease across the world. It is common in post-menopausal women due to decreased protective effects of estrogen (El Khoudary et al., 2020). The disease is often missed in women compared to men because they present with mild symptoms. Their joint presentation is body weakness, discomfort at the back, and shortness of breath, unlike the usual presentations of chest pain, palpitations, difficulties in breathing, heartburn, nausea, abdominal pain, dizziness, orthopnea, and lower limb swelling. Additionally, heart diseases in women are a common complication of pregnancy, pre-eclampsia, and hysterectomy (Woodward, M. 2019)The Cardiovascular Screening For Women Assignment Paper. Factors affecting the accuracy of cardiovascular disease diagnosis in women, such as false positive st changes in post-menopausal women, reduced functional capacity due to other comorbidities, and lower prevalence due to the absence of risk factors.

Prevalence Of Cardiovascular Diseases

Vulnerable populations with heart diseases are psychiatric patients on psychotropics, low social and economic status, and elderly patients. This group of patients have no access to primary healthcare services due to a lack of medical insurance coverage (El Khoudary et al., 2020). Psychiatric patients have poor cognitive abilities and insight to help them identify their illnesses. Additionally, psychotropics have undesirable side effects, such as cardiac arrhythmia, hypertension, and bradycardia. They also alter the metabolism of lipids and glucose causing hyperlipidemia, weight gain, and diabetes mellitus. Mental health diseases such as depressive mood and bipolar cause the patient to adopt unhealthy lifestyles such as physical inactivity, use of drugs, and smoking (Zambrano et al., 2020). Intravenous drug users have a high risk for heart diseases (infective endocarditis and valvular heart disease)The Cardiovascular Screening For Women Assignment Paper.

Screening Modalities in heart diseases

Training healthcare providers should undergo training to assess cardiovascular diseases and the risk factors for preventive measures and treatment. Most women in healthcare facilities are asymptomatic, have several risk factors, and have mild to moderate symptoms of heart disease. The care providers should screen for the signs and risk factors. The high-risk patient should proceed to investigate for heart disease through an electrocardiogram ECG to determine the rate of heartbeat, its rhythm, and the strength of heart contraction (Shabaan et al., 2020). ECG is a basic test that determines the severity of heart disease. An echocardiogram is a non-invasive test that shows the heart’s contraction and the valves’ efficiency (Orchard et al., 2019)The Cardiovascular Screening For Women Assignment Paper. It is essential in patients with symptoms of heart disease. Cardiac catheterization shows the blockage of arteries and is effective in diagnosing coronary heart diseases and embolisms.

The essence of screening healthy patients is to create awareness, provide medical education on the risk factors and symptoms of the disease, and provide counselling services on lifestyle modification and therapeutic interventions. For example, obese women with hypertension are educated on the risk of heart disease and hyperlipidemia,  prophylactic medication such as aspirin and adapting to a healthy diet and physical exercise reduces the progression to heart disease (Raber et al., 2019). Early diagnosis ensures prompt treatment, lifestyle modification, and monitoring of disease progression (Kanejima et al., 2022). Screening patients with the pre-existing cardiovascular disease helps re-classify, control the risk factors, and provide optimal medical therapy to delay disease progression and prevent recurrent events.

Ethical Considerations In Screening

Detecting diseases or the risk factors of a disease helps in early treatment or prophylaxis initiation to prevent morbidities and mortalities. The decisions made during cardiovascular disease screening are guided by the ethical principles in nursing. These are beneficence, consent, autonomy, non-maleficence, and confidentiality (Shrestha et al., 2022). The provide an informed consent for treatment or initiation of prophylactic therapy. Therefore, the nurse should explain to the patient about her medical findings, diagnosis, and the treatment plan. The nurse should provide a treatment that has therapeutic benefits to the patient. Non-maleficence is the ability to protect patient from medical harm (Elton, 2021)The Cardiovascular Screening For Women Assignment Paper. In psychiatric patients, the nurse should evaluate the possible drug to drug interactions that may cause adverse effects on the patient.

Psychiatric Patients Screening

A psychiatric nurse practitioner should screen their patients for heart diseases by evaluating their symptoms, asking about family history of heart diseases, and physical examinations. The nurse practitioner should carefully assess the drug for interactions that may precipitate a cardiac condition (Zambrano et al., 2020). Counsel on healthy lifestyle modification of adopting a healthy diet and physical exercise because they have a higher risk for hypertension, obesity, and hyperlipidaemia. For example, risperidone is an antipsychotic FDA-approved for schizophrenia. It is associated with an irregular heartbeat and qt prolongation, increasing the risk of heart failure, angina, and arrhythmia (Beauchemin et al., 2020)The Cardiovascular Screening For Women Assignment Paper. Therefore, risperidone is contraindicated in patients at risk of cardiovascular diseases.

Conclusion

Cardiovascular diseases affect the heart muscles and the blood vessels. The risk factors are physical inactivity, a high-calorie diet, saturated fats, sugars, and metabolic syndrome. Cardiovascular diseases are common in women, people of low socioeconomic status, patients on other medication, psychiatric conditions, the elderly, and ethnic minorities. The essence of screening healthy patients is to create awareness, provide medical education on the risk factors and symptoms of the disease, and provide counselling services on lifestyle modification and therapeutic interventions. A psychiatric nurse practitioner should screen their patients for heart diseases by evaluating their symptoms and the risk of cardiac diseases

References

Beauchemin, M., Geguchadze, R., Guntur, A. R., Nevola, K., Le, P. T., Barlow, D., … & Houseknecht, K. L. (2020). Exploring mechanisms of increased cardiovascular disease risk with antipsychotic medications: Risperidone alters the cardiac proteomic signature in mice. Pharmacological research, 152, 104589. https://doi.org/10.1016/j.phrs.2019.104589

El Khoudary, S. R., Aggarwal, B., Beckie, T. M., Hodis, H. N., Johnson, A. E., Langer, R. D., … & American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. (2020). Menopause transition and cardiovascular disease risk: implications for timing of early prevention: a scientific statement from the American Heart Association. Circulation, 142(25), e506-e532. https://doi.org/10.1161/CIR.0000000000000912

Elton, L. (2021). Non-maleficence and the ethics of consent to cancer screening. Journal of Medical Ethics, 47(7), 510-513. https://doi.org/10.5840/soctheorpract2022218152

Kanejima, Y., Shimogai, T., Kitamura, M., Ishihara, K., & Izawa, K. P. (2022). Impact of health literacy in patients with cardiovascular diseases: A systematic review and meta-analysis. Patient Education and Counseling, 105(7), 1793-1800. https://doi.org/10.1016/j.pec.2021.11.021

Orchard, J. J., Neubeck, L., Orchard, J. W., Puranik, R., Raju, H., Freedman, B., … & Semsarian, C. (2019). ECG-based cardiac screening programs: Legal, ethical, and logistical considerations. Heart Rhythm, 16(10), 1584-1591. https://doi.org/10.1016/j.hrthm.2019.03.025

Raber, I., McCarthy, C. P., Vaduganathan, M., Bhatt, D. L., Wood, D. A., Cleland, J. G., … & McEvoy, J. W. (2019). The rise and fall of aspirin in the primary prevention of cardiovascular disease. The Lancet, 393(10186), 2155-2167. https://doi.org/10.1016/S0140-6736(19)30541-0

Shabaan, M., Arshid, K., Yaqub, M., Jinchao, F., Zia, M. S., Bojja, G. R., … & Munir, R. (2020). Survey: smartphone-based assessment of cardiovascular diseases using ECG and PPG analysis. BMC medical informatics and decision making, 20, 1-16. https://doi.org/10.1186/s12911-020-01199-7

Shrestha, P., Van Pilsum Rasmussen, S. E., King, E. A., Gordon, E. J., Faden, R. R., Segev, D. L., … & McAdams-DeMarco, M. (2022). Defining the ethical considerations surrounding kidney transplantation for frail and cognitively impaired patients: a Delphi study of geriatric transplant experts. BMC geriatrics, 22(1), 566. https://doi.org/10.1186/s12877-022-03209-x

Woodward, M. (2019). Cardiovascular disease and the female disadvantage. International journal of environmental research and public health, 16(7), 1165. https://doi.org/10.3390/ijerph16071165

Zambrano, J., Celano, C. M., Januzzi, J. L., Massey, C. N., Chung, W. J., Millstein, R. A., & Huffman, J. C. (2020). Psychiatric and psychological interventions for depression in patients with heart disease: a scoping review. Journal of the American Heart Association, 9(22), e018686. https://doi.org/10.1161/JAHA.120.018686 The Cardiovascular Screening For Women Assignment Paper

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Cardiovascular Screening for Women: A Narrative Paper

Introduction

In the United States, cardiovascular diseases are the primary cause of death for women, accounting for around one-third of all fatalities (Grandi et al., 2019). This problem affects women’s health globally because cardiovascular disease risk rises with age and is more prevalent in women of color (Groenewegen et al., 2020). According to studies, cardiovascular disease is the main reason women die in Europe, North America, and Asia (Hashemzadeh et al., 2019). Women with additional risk factors for cardiovascular diseases, such as smoking, diabetes, and a family history of the condition, are at an increased risk (Vogel, 2021). Therefore, it is crucial to take preventative steps to lower the risk of cardiovascular disease in women. Cardiovascular screening is one such prophylactic measure. Cardiovascular screening detects people at risk for developing cardiovascular disease and offers them therapy or lifestyle changes to lower that risk (Woodward, 2019)The Cardiovascular Screening For Women Assignment Paper. This paper will discuss the importance of cardiovascular screening for women, provide an overview of the literature related to the topic, and discuss one foundational theory related to the issue.

Provider PICOT elements and research question

• Population: Providers working in outpatient clinics
• Intervention: Educational session aimed at increasing cardiovascular screening in women with heart disease
• Comparison: Women with heart disease who did not receive cardiovascular screening
• Outcome: Mortality rates (reduced vs. not reduced)The Cardiovascular Screening For Women Assignment Paper
• Time frame: 3 months

The research question that follows from these elements is: In outpatient clinics, do providers who receive an educational session on conducting cardiovascular screening and managing modifiable risk factors in women with heart disease have a higher rate of cardiovascular screening than providers who do not receive the intervention? Does this result in a reduction in mortality rates over three months?

Population: In particular, doctors, nurse practitioners, physician assistants, nurses, medical assistants, receptionists and front desk personnel, referral coordinators, quality improvement personnel, and practice managers will participate in this study. These healthcare professionals will participate in a training session to enhance cardiovascular screening among heart disease-stricken women.

Intervention: The educational session will go through the American Heart Association’s recommendations for preventing cardiovascular disease in women, the CDC’s recommendations for cardiovascular screening, and the National Heart, Lung, and Blood Institute’s recommendations for treating high blood pressure (Grandi et al., 2019)The Cardiovascular Screening For Women Assignment Paper. Discuss The discussion will also cover the value of cardiovascular screening in women with heart disease, methods for raising screening rates, how to conduct a cardiovascular screening and interpret the results, handling modifiable risk factors, typical screening-related roadblocks, patient education resources, and follow-up schedules. Using PowerPoint, handouts, discussion, and case-based examples, the event will be a face-to-face lecture that will enable interaction and the clarification of doubts and concerns from the audience. Written materials, such as a summary or cheat sheet of key points covered during the educational session, will be provided, along with reminders to be incorporated into the EHR system to prompt healthcare providers to conduct cardiovascular screening in eligible patients and reminders to be sent to patients who are due for cardiovascular screening.

Comparison: The comparison group will be women with heart disease who did not receive cardiovascular screening. This will allow for a comparison of mortality rates between the two groups.

Outcome: The outcome of this research will be measured by chart review. The expected behavior change in the providers after the educational intervention is an increase in the rate of cardiovascular screening in women with heart disease (Hashemzadeh et al., 2019)The Cardiovascular Screening For Women Assignment Paper. This can be measured by comparing the rate of cardiovascular screening in eligible patients before and after the educational intervention using a statistical test such as a chi-square test or a t-test, depending on the data collection type.

Time: Data collection will be done for three months after the educational intervention. This will allow for enough time to measure the intervention’s outcomes and compare the two groups’ mortality rates.

PICOT elements for the patient population and research question

• P: Women with heart disease seen in outpatient clinics
• I: Cardiovascular screening
• C: No screening
• O: Mortality rates
• T: 3 months

In women with heart disease seen in outpatient clinics, does receiving cardiovascular screening compared to no screening result in a reduction in mortality rates over three months as measured by chart review?

Population: The population of this study will include female patients of all ages with a confirmed diagnosis of heart disease. Patients with comorbidities such as hypertension, diabetes, obesity, and smoking history may also be relevant for the study (Hashemzadeh et al., 2019)The Cardiovascular Screening For Women Assignment Paper. Patients who cannot provide informed consent, attend educational sessions or follow-up appointments, and have already received cardiovascular screening within the past three months will be excluded.

Intervention: The intervention in this study will include lifestyle modifications, medications, medical procedures, and cardiac rehabilitation. Lifestyle modifications include regular exercise, maintaining a healthy weight, following a heart-healthy diet, quitting smoking, and managing stress (Grandi et al., 2019). Medications may include aspirin, beta-blockers, ACE inhibitors, and statins to help manage symptoms and reduce the risk of complications. Medical procedures such as angioplasty, stenting, or bypass surgery may be necessary to improve blood flow to the heart. Cardiac rehabilitation is a structured program that includes exercise, education, and counseling to help patients recover from a heart attack or other cardiac event and reduce their risk of future events.

Comparison: The comparison group will receive the same treatment as the intervention group, except without cardiovascular screening. The treatment plan for the comparison group may include medication to control blood pressure, cholesterol levels, and heart rate, as well as lifestyle modifications such as a healthy diet, regular exercise, and weight management.

Outcome: The outcomes of this study will be measured using a chi-square test to compare the proportion of patients screened before and after the educational intervention. The patient’s behavioral or physiological response, such as acceptance to get lab tests for A1C or using a step app on the phone, can be measured using a t-test (Hashemzadeh et al., 2019)The Cardiovascular Screening For Women Assignment Paper. The duration of time used to collect outcome data for patients receiving the intervention is at least three months.

Time: The study will determine whether women with heart disease who receive cardiovascular screening have a reduced mortality rate compared to women without screening over three months (Vogel, 2021). The results of this study will provide valuable insight into the potential benefits of screening for women with heart disease and may lead to improved treatments and prevention strategies. This research could help to reduce mortality rates in this population and improve the quality of care for women with heart disease. Additionally, the findings from this study could also lead to a better understanding of preventive health measures for heart disease in women.

Review of the literature (ROL)

Data Bases and Search Terms:

The search for information related to women and heart disease using search engines such as PubMed and Google Scholar. The keywords used to search were “women,” “heart disease,” “cardiovascular screening,” “mortality,” “patient education,” “provider education,” and “guideline adherence.”

PICOT Elements

This PICOT statement is designed to examine the effects of cardiovascular screening and patient/provider education on female patients with heart disease seen in outpatient clinics over three months (Grandi et al., 2019)The Cardiovascular Screening For Women Assignment Paper. The goal of this study is to determine whether cardiovascular screening and education intervention will lead to a reduction in mortality compared to those who do not receive the intervention.

Education for Providers

Provider and patient education is crucial for reducing morbidity and mortality related to heart disease. The Cochrane Review (Vogel, 2021) outlines evidence-based practices that providers should use in educating their patients. Specifically, providers should focus on teaching patients about cardiovascular screening, management of modifiable risk factors, and adherence to treatment plans. Through education, providers and patients can work together to reduce the effects of heart disease. By understanding the risks, symptoms, and treatments associated with heart disease, patients can take the necessary steps to reduce their risk and increase their quality of life. Through provider education, healthcare staff are better equipped to provide the best advice and care for their patients. Patients who are informed and have access to the most up-to-date information can make better decisions for their health and well-being. Educating both providers and patients is key to reducing morbidity and mortality associated with heart disease.

Clinical problems and barriers to guideline adherence: Clinical problems and barriers to guideline adherence pose an increasing threat to the global burden of heart disease in women. A systematic review and meta-analysis by Grandi et al. (2019) found that women with a history of pregnancy complications are at an increased risk of cardiovascular disease-related morbidity and mortality. Woodward discussed the female disadvantage in cardiovascular disease, including under-diagnosis and under-treatment (Woodward, 2019). Groenewegen et al. (2020) provided an overview of the epidemiology of heart failure, a common cardiovascular complication in women with heart disease.

The best evidence for provider and patient education: The best evidence for provider and patient education involves provider education interventions that can improve guideline adherence and patient outcomes (Grandi et al., 2019)The Cardiovascular Screening For Women Assignment Paper. Patient education interventions tailored to the individual patient’s needs and preferences have effectively improved patient knowledge and self-management skills.

Literature on All PICOT Elements

Grandi et al. (2019) conducted a systematic review and meta-analysis to comprehend the PICOT framework fully. They discovered that women with a history of pregnancy problems were more likely to experience cardiovascular disease-related morbidity and mortality. The transtheoretical model of behavioral health change, discovered to be a valuable tool for raising the rate of health screenings, was the subject of a systematic review by Hashemzadeh et al. in 2019. By 2030, Vogel et al. (2021) suggested a thorough strategy for lowering the burden of cardiovascular disease on women worldwide. Groenewegen et al. (2020) gave an overview of the epidemiology of heart failure, and Woodward (2019) discussed the gender differences in heart disease.

Foundational Theory

The Self-Care Deficit Theory of Dorothea Orem is a relevant nursing theory for this research project. This theory is based on the idea that individuals have a natural capacity and desire to care for themselves. Still, when their ability to do so is compromised due to an illness or injury, they need nursing care to meet their needs. The theory proposes three key constructs: self-care, self-care deficit, and the nursing system (Vogel, 2021)The Cardiovascular Screening For Women Assignment Paper. Self-care refers to individuals’ activities to promote health and well-being. A self-care deficit occurs when a person cannot perform the necessary self-care activities due to illness, injury, or other conditions. Finally, the nursing system refers to the interventions and actions healthcare providers take to support an individual’s self-care and address deficits.

In the context of this research project, the Self-Care Deficit Theory can be used to guide the development and implementation of cardiovascular screening and patient/provider education intervention. By providing education and support, healthcare providers can empower women with heart disease to engage in self-care activities that promote their health and well-being, ultimately reducing mortality rates. Additionally, by identifying and addressing any self-care deficits, healthcare providers can develop individualized plans of care tailored to each patient’s unique needs. The 3-month time frame of the research project aligns well with the theory as it provides a sufficient period to evaluate the effectiveness of the nursing system interventions on the patients’ self-care and mortality rates.

Conclusion

In conclusion, this PICOT statement provides valuable insight into the effects of cardiovascular screening and patient/provider education on female patients with heart disease seen in outpatient clinics over three months. By utilizing the Self-Care Deficit Theory of Dorothea Orem, healthcare providers can empower women with heart disease to engage in self-care activities that promote their health and well-being, ultimately reducing mortality rates and improving the overall quality of life. The findings from this research project will provide evidence-based information that can be used to inform practice and policy.

References

Grandi, S. M., Filion, K. B., Yoon, S., Ayele, H. T., Doyle, C. M., Hutcheon, J. A., … & Platt, R. W. (2019). Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications: systematic review and meta-analysis. Circulation, 139(8), 1069-1079. https://scholar.google.com/scholar?output=instlink&q=info:ltpiD698lE0J:scholar.google.com/&hl=en&as_sdt=0,5&as_ylo=2019&scillfp=7540320581852608597&oi=lle

Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart failure. European journal of heart failure, 22(8), 1342-1356. https://scholar.google.com/scholar?output=instlink&q=info:Ep6LATRvMrsJ:scholar.google.com/&hl=en&as_sdt=0,5&as_ylo=2019&scillfp=5011631833264359503&oi=lle

Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A. M., & Daei, A. (2019). The transtheoretical model of behavioral health change: A systematic review. Iranian journal of nursing and midwifery research, 24(2), 83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390443/

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Vogel, B., Acevedo, M., Appelman, Y., Merz, C. N. B., Chieffo, A., Figtree, G. A., … & Mehran, R. (2021). The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. The Lancet, 397(10292), 2385-2438. https://us2.ai/wp-content/uploads/2022/04/Lancet-Women-and-CVD-Commission.pdf

Woodward, M. (2019). Cardiovascular disease and the female disadvantage. International journal of environmental research and public health, 16(7), 1165. https://www.mdpi.com/1660-4601/16/7/1165/pdf The Cardiovascular Screening For Women Assignment Paper