Last week we began gathering ideas on our PICOT question for this week. After reading other students post and receiving feedback from the instructor, I realized I had to focus in more on one specific topic. In my practice, I meet a lot of patients that tell me about their experience leading up to their heart attack or the stenosis in their arteries requiring intervention. A common theme seems to be that a doctor notices lab work that requires attention, such as cholesterol levels. These doctors explain to the patients why the numbers are important and then send them home on a stain drug. Stain drugs are an extremely common medication given to patients in the high-risk category of CVD. The hope is that the medicine will reduce the instances of heart attacks and other damaging effects of CVD. However, the overall use and patient consistency with statin use is not well documented (Borja?Hart et al., 2019). What I want to know is if gathering more in-depth data about patients, things from waist measurements, activity level, and socioeconomic status, would further provide information to identify at risk patients before they end up with a heart intervention like they do on my unit. For that reason, my PICOT question is the following:
In adults ages 55-65 years old, what is effect of completing an in-depth risk assessment for cardiovascular disease compared to the usual annual care and basic lab work for other patients on the incidences of heart attacks over the course of five years.
The more time you spend researching CVD and its risks, the more you come to realize just how multifactorial it truly is. Concerns with diet are always high, such as diets high in salt and fat. Recent studies have shown that a healthy variety plant-based diet help to lower the risk of CVD among all demographics of patients, regardless of genetic susceptibility (Heianza et al.). Studies like these are going to be key to properly decide which risk factors to be included in an in-depth assessment. Diet plays such an important role in all aspects of our health, and I believe we as practitioners can include this more appropriately in our practice with better education and resources. Socioeconomic status is also shown to be a huge indicator with risk of CVD disease. Early understanding of patients with impaired ability to properly nourish themselves and understand their disease has been shown to improve patient outcomes. Since patients who come from a background of higher education, who also statistically make more income, show a much lower risk of CVD disease, basic understanding of our patient demographic will allow us to choose the appropriate interventions for each patient (Nadrowski et al., 2019). Early in school we all learned how important assessment is in the nursing process, we must not forget to continue to develop this skill and always provide the best care to our patients, and we do that by better understanding them.
Borja?Hart, N., Graff, J. C., Nolan, V. G., Wang, J., Cooper?Dehoff, R. M., & Ancheta, I. B. (2019). Atherosclerotic cardiovascular disease risk assessment and predictors of statin use in Filipino?American Women. Journal of Clinical Pharmacy and Therapeutics, 44(4). doi:10.1111/jcpt.12837
Heianza, Y., Zhou, T., Dianjianyi, H., Frank, M., & JoAnn E, Q. (n.d.). Genetic susceptibility, plant-based dietary patterns, and risk of cardiovascular disease. American Journal of Clinical Nutrition, 112(1), 220-228. Retrieved November 02, 2020, from https://web-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/ehost/detail/detail?vid=7&sid=ff5f9f31-a9ca-49c3-8d0c-1cba9564e5a8%40sdc-v-sessmgr02&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=c8h&AN=144382967.
Nadrowski, P., Podolecka, E., Pajak, A., Dorynska, A., Drygas, W., Bielecki, W., . . . Kozakiewicz, K. (2019). How does the risk of cardiovascular death and cardiovascular risk factor profiles differ between socioeconomic classes in Poland: A country in transition. Cardiology Journal, 26(5), 493-502. doi:10.5603/cj.a2018.0003
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