Because of the rising number of heart failure cases among the elderly, which can easily lead to death, it is becoming more important for the South Australian Health Omnibus to be prepared to deal with such emerging issues. According to the survey, approximately 373 respondents (2.0 percent of the total population and 4.9 percent of caregivers) are said to care for elderly people with heart failure (Davidson et al, 2013). Each year, however, cases of heart failure are reported. Out of all elderly individuals, chronic heart failure results in nearly one hundred thousand hospitalizations in each year and in most known hospitals discharge diagnosis in the patients above the age of 65 years. In dealing with heart failure emergencies, it is the responsibility of the South Australian Health Omnibus nurses to organize and be prepared to tackle the problem (Davidson et al, 2013). This involves taking care of the patients with heart failures without taking into account total amount lost and productivity which cost the society thousands of dollar in each year. So The PICOT question being explored in this paper is "Are the elderly individual who has present palliative care takers at decreased risk of death compared with the elderly individual without care takers over the period of five years heart failure emergency?" P is representing heart failure patients, I is representing care given to the patient, C is comparing patients who are receiving palliative care with those who do not receive care, O is denoting heart failure management and T is representing five year period of heart failure emergency?
Nursing research plays an important role in understanding nursing practices carried out in nursing and medical profession. The knowledge acquired and skill practiced by the nurses are obtained from proper evidence-based research. This evidence-based research approves the most recommended ways to handle each of the identified problems. That is to say, if nurses or caregivers follow the instructed guidelines set for each problem, they will be able to protect themselves, patients and provide the best care to the patient (Grove, Gray, & Burns. 2015). Therefore, when researching for the PICOT question presented above, the study utilized relevant nursing/medical databases such as Cinahl, Cochrane Reviews, and Pub-Med. From the databases, advanced search is carried out where applicable and the key words and nursing phrases are included. This gives versed knowledge and understanding of nursing practices based on the topic under study. The research further after going through abstracts of various articles narrowed the reading by selecting which articles to include and which ones to exclude. The concept included in this study was obtained from articles that were published 5 years ago to present, with much from "The caregiving perspective in heart failure: a population based study" and "Understanding nursing research: Building an evidence-based practice" (Grove, Gray, & Burns. 2015). Nursing or care givers must collaborate with related personnel in supporting evidence-based practices and ensuring they are practiced in their daily activities "Nurses interpret research findings and use evidence-based research to support nursing decisions. The purpose of this assignment is to reflect how nursing knowledge is disseminated for use in personal and professional practice" (Singleterry, (2014), pg.7).
In our research paper, South Australian nurses (caretakers) were evaluated in order to determine their experience and attention which has been put into practices on "left ventricular (LV) dysfunction, loading conditions, and neuroendocrine activation as pathophysiological mechanisms for progression of heart failure", and factors that hinders implementation of the practices. The article reveals that more than 80% of serious care is given by nurses in the society other than close relatives of the diseased person (Davidson et al, 2013). Much of the data collected concerning the care givers was obtained in the hospitals and the period of post discharge accessed immediately. According to the studies carried out in Austria, the average referral period from palliative care services given to the death of the patient is 102 days which denote 28.5% of the patient receiving palliative care for a period greater than half a year nationally (Davidson et al, 2013). This is contrary to international patterns where the proportion of the individuals with the less harmful condition of heart failure accessing nurses palliative care services is increasing day by day. Caregiving practices could allow South Australian Health Omnibus to apply them where a patient with heart failure happened not to seek medical attention or if their relatives are found not to take proper medical attention and care in case of heart failure emergency. This practice involves left ventricular correction, loading condition control and neuroendocrine measures. In such situations, the South Australian nurse's proves that realization and administration of the correct measures to the patients can prevent immediate death and serious suffering to the elderly individuals who are affected as explained in (Davidson et al, 2013).
Reliability of the study is drawn from the consistency realized from the measurement methods used in (Davidson et al, 2013) article. Criticizing the reliability of the Davidson et al. (2013) article, they used surveys that targeted at the; orientation, skills, knowledge, and preparation of South Australian Health Omnibus on matters pertaining to heart failure. The survey was conducted by the author for the purpose of getting the perception of the community on caregiving practices. Prior to the survey, a pilot study was conducted to ensure consistency of the sample question in the questionnaires and to ease answering of the questionnaires. Cronbach's alpha is the recommended test of internal reliability. Therefore, α> 0.7 indicates strong internal consistency. The surveys were conducted anonymously using stratified random sampling by selecting one person in each household implying the article was highly reliable in terms of data collection and methods used in measurements as in (Davidson et al, 2013).
On the other hand, validity explores how the instrument used in the study overview the concept in the abstract and topic being investigated as stated in (Grove et al., 2015, p. 290). Challenging the validity of the study as illustrated in Davidson et al. (2013) article. Descriptive statistics and cross-sectional (cross-tabulation) was used in their study. The study tries to "analyze current practices in caregiving, pin points areas of concentration and identifies how the topic would benefit from further study" in comparison to the palliative care and life span of heart failure to an elderly patient. The questions in the article were created with a lot of expertise by incorporation pilot survey to maintain information validity. Generally, the author reflected the validity of the study in both research design and measurement methods as shown in (Davidson et al, 2013).
From a close analysis of the article, there are some of disadvantages and advantages in the study. Beginning with the challenges, interpretation of data used in the study should be taken with the proceeding of a descriptive cross-section and retrospective perception and the limitation of a designed questionnaire item is that it is subjected to a detailed comprehensive psychometry. More so, the report used is obtained from proxies to evaluate the patient comfort, service received and location of their death which is reproduced at the end of the diseased life. In addition, symptom control during fatal phases of life threatening sickness like heart failure is time to time used in palliative care research due to challenges experienced in the research by involving people with life threatening illness as in (Davidson et al, 2013). Advantages of the study are that it provides the building data to educate the best practices to be incorporated for the purpose of supporting individuals with heart failure. Adding to that, the sampling procedure followed by the South Australian Health Omnibus creates a wide representative sample of the entire community instead of using caregivers to investigate perceived attitude towards care and comfort, application of independent surveys minimized the probability of biased positive indicators of service provision as explained in (Davidson et al, 2013).
According to "The situation of caregivers in heart failure and their role in improving patient outcomes" it is explained by emphasizing the importance of caregivers understanding the symptoms of the individual with heart failure as early as possible (Stromberg, 2013). Most elderly individuals may give general symptoms, some which may not reveal the problem they are suffering from. However, identifying the symptoms may not be helpful as such, but looking for the recommended care and treatment for heart failure victims may increase the life span of the affected individuals as a note in (Stromberg, 2013).
Heart failure cases having been noted to be increasing among the elderly people. It is equally important for South Australian health omnibus to be prepared to act on the emerging cases of heart failure with immediate effect. As noted earlier it cost hearth Omnibus thousands of dollars yearly to take care of the affected individuals. Therefore, despite its negative effect to the caregivers and the entire Centre, they should not fail to administer palliative care to the patient. This should be treated with a lot of humanity in order to help individuals who cannot afford the cost treatment and care given (Stamp, Dunbar & Clark, 2014). So it is clear that availability of caregivers and palliative care to the patients with heart failure can decrease the risk of death as in (Stamp, Dunbar & Clark, 2014).
To sum up, are the elderly individual who has present palliative care takers at decreased risk of death compared with the elderly individual without care takers over a period of five years heart failure emergency? It is noted from the study that administering palliative care to the elderly individual with heart failure by nurses or caregivers decreases the risk of death to the individual receiving the care than those who do not receive it. This implies that South Australian Health Omnibus are recommended to train more caregivers in order to ensure every individual suffering from heart failure is receiving some nursing practices, as it would be helpful in prolonging their life as stated in (Davidson et al, 2013).
REFERENCES
Davidson et al.: The caregiving perspective in heart failure: a population based study. BMC Health Services Research 2013 13:342.
Grove, S.K., Gray, J.R., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.). St. Louis, MO: Elsevier Saunders.
Stamp KD, Dunbar SB, Clark PC, et al. Family context influences psychological outcomes of depressive symptoms and emotional quality of life in patients with heart failure. J Cardiovasc Nurs 2014; 29: 517–527.
Stromberg A: The situation of caregivers in heart failure and their role in improving patient outcomes. Curr Heart Fail Rep 2013, 10(3):270–275.
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