Prevention of The Readmission of Atrial Fibrillation

Abstract

The topics discussed include the definition of atrial fibrillation, and how to prevent readmission to the hospital for patients. This will include education of atrial fibrillation by staff, medication compliance, and routine follow up visits with a cardiologist. There will also be a description of potential barriers patients face during discharge. This includes the lifestyle changes needed, finances needed to obtain the medications, and any potential chronic conditions that may worsen or keep the patient from controlling their atrial fibrillation. There will be multiple research topics provided in the text of what are some successful techniques as well as how we can combat the potential barriers for the patients to prevent readmission to the hospital.

Atrial fibrillation is a common cardiac arrhythmia. The heart rate becomes irregular due to the atria quivering. The heart then becomes unable to pump blood effectively throughout the body and causes symptoms like tachycardia, palpitations, fatigue, shortness of breath, anxiety, and chest discomfort. Due to the decreased cardiac output because of the AF this can lead to increased risk of transient ischemic accidents, ischemic stroke, systemic embolism, and even death. Atrial fibrillation is usually brought on by a trigger. Patients with valvular heart diseases, congestive heart failure and ischemic heart disease have a greater chance at being diagnosed with chronic AF.

Patients need to be able to manage and understand their diagnosis of atrial fibrillation in order to prevent re-admission to the hospital setting. It starts with the education process by the staff to help teach them about the diagnosis. Medication compliance also needs to be taught for the risks and benefits, and finally the follow up appointments with a cardiologist need to be discussed. Some patients are going to struggle and this creates barriers that will eventually lead them into readmission back to a hospital. This can include they may not be able to change their lifestyle, financial decisions about keeping up to date with medications, or even not being able to care for another chronic condition which can make the AF worse.

Literature Review

In order to prevent atrial fibrillation readmission to a hospital there needs to be education about the diagnosis for the patient. The nurses should provide education for the patient so they understand how to self-manage the diagnosis. The patients should be taught how to check their own heart rate and blood pressure the patients’ need to be aware of the possible risk factors that can happen such as stroke if they are unaware of their diagnosis. The next step is that patients need to understand the medications that they are taking, and why they are taking them. They need to be educated on anticoagulant medications as well as any beta blockers or other anti-arrhythmic medications that they will be taking. This includes the potential side effects, such as bleeding from the anticoagulant or low blood pressure and heart rate from the beta blocker. The final step is to help the patient schedule any follow up exams with a cardiologist in order to make sure the medications that they are taking do not need to be altered and are appropriate for the patient. You want to make sure the patient is aware they are taking the correct amount of medication to control their atrial fibrillation.

The potential barriers a patient can face with atrial fibrillation being with the new lifestyle changes. This includes dietary interactions between medications and need for possible INR monitoring if they are on Warfarin. Another barrier a patient may face is they may not be able to afford the medications needed. Between hospital visits, insurance plans and prescription drug costs patients may not be able to have access to the medications that they need. This creates frequent visits to the hospital instead. A final barrier for patient s could be they may not be able to care for their primary chronic condition and thus worsening the atrial fibrillation due to not being compliant with medications. Patients who have previous chronic conditions, have a lesser chance at medication compliance. This could include mental health problems, diabetes mellitus, sleep quality, memory decline, or poor physical health.

Conclusion

In conclusion, atrial fibrillation is a common cardiac arrhythmia that can be controlled to prevent hospital readmission. This requires patient education on the diagnosis, compliance with medications, and helping the patient self-manage the diagnosis. The barriers that healthcare providers face are compliance with lifestyle changes needed, financial difficulties and compliance with the medications along with treating chronic health conditions to prevent the worsening of atrial fibrillation.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759971/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709951/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589479/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371431/