Preventing Heart Disease

Travis Cox

As of 2007, heart disease is the leading cause of death in the United States and it includes a variety of diseases relating to the heart (AHA, 2007). Heart disease is very costly and creates quite a burden for the patients affected as well as their families.

As of 2007, heart disease is the leading cause of death in the United States and it includes a variety of diseases relating to the heart (AHA, 2007). Heart disease is very costly and creates quite a burden for the patients affected as well as their families. With nursing education, heart disease can be reduced. It can also help maintain the health of patients at risk or those who have been diagnosed with heart disease. Nurses have the proper training and are more cost effective than using physicians for educational means. With proper nurse education and intervention through nurse led clinics, clients who either have heart disease or are at risk for heart disease will have significantly better quality of life. Heart disease targets people who are with hypercholesterolemia, have hypertension, hyperglycemia, which are smokers or, TABP (Type A Behavior Patterns) which has been recently added to the list (AHA, 2007). Because these problems are very prominently found in today’s society, heart disease is common and hard to avoid. In 2005, it was estimated that the cost of heart disease in America was $394 billion (CDC, 2005). This ever-increasing problem can be avoided or managed by maintaining basic day to day activities which include: decreasing cholesterol in daily diet, avoiding obesity by regular exercise, avoiding a sedentary lifestyle, smoking cessation, controlling diabetes and having regular check ups and health screenings. (CDC, 2005) As a nurse, strategies such as education, screenings in outpatient clinics and community screening can lead to a decrease in heart disease and better lives for those with heart disease.

There are many techniques that a nurse can utilize when educating people on the importance of preventing heart disease. Diet, exercise and smoking are three main categories that ought to be addressed. The American Heart Association has many pamphlets and brochures that talk about strategies and methods to prevent this disease (AHA, 2007). Education should focus on the methods used to prevent heart disease such as reducing cholesterol, lowering salt intake and avoiding obesity. Avoiding foods high in saturated and trans fat can help reduce cholesterol. One of the biggest obstacles for this issue is educating those in poverty who find it easier and cheaper to eat a ninety-nine cent high fat cheeseburger then to buy fresh fruits and vegetables from the grocery store (Wright, 2007). Preventative diets include ones high in vegetables and fruits as well as avoiding large quantities of red meat and foods high in Omega-3 fatty acids (found in many seafood products). One of the most common preventative diets is the Mediterranean style diet which consists mainly of olive oil, bread, abundant fruit and vegetables, a moderate amount of wine, and animal products such as lamb, sausage and goat cheese (Wright, 2007). Exercising regularly can also help to reduce the risk of heart disease. It is recommended that the average adult get 30 minutes of moderate exercise 5 times a week (AHA, 2007). Nurses should also promote smoking cessation programs or products that can help people to stop smoking such as nicotine gum or patches. There are nearly 135,000 smoking-related cardiovascular disease deaths per year (AHA, 2007). Education on this matter can be the first step to promoting a healthy lifestyle and reducing the occurrence of heart disease.

Along with education, people screened early and screened often have a better chance of avoiding or fighting heart disease. Nurse led clinics have been a proven resource in reducing the number of people with heart disease as well as improving the lifestyle of those with heart disease (CDC, 2005). Studies involving three different styles of outpatient teaching methods and screenings were done and compared in 2001. These studies showed that people responded to and were more apt to attending nurse led clinics. The study compared hospital screening, physician run clinics and nurse led clinics. The results showed that the nurse run clinics had more visitors with a better rate of identifying patients at risk. They also had better follow up care and better education retention with an overall 85% success rate and a 33% better overall experience according to patients (Campbell, 2005). Nurse led clinics also were more cost effective per patient with better success rates according to a 2005 study which showed that nurse led clinics can thrive financially in a community while serving a valuable purpose (Berg, 2007). Clients at these clinics receive advanced screenings based on their predisposition to heart disease. They will receive proper education, screening for blood pressure and cholesterol and monitoring for patients with heart disease to help them get on track (Berg, 2007).

Besides nurse led clinics, nurses can help educate and screen in the community. Mobile operation centers such as school and office screenings can be set up with correspondence to the American Heart Association (AHA, 2007). These mobile screenings can have a significant impact in catching people pre disposed or those who may have early signs of heart disease but have not yet been diagnosed. These early tests (education, cholesterol and blood pressure screening) can save a life as well as start someone down the right path in getting well. These early warning stations can also be a very helpful resource for preventative education.

Strategies such as education and early detection are the absolute key to preventing heart disease. Nurses can be a valuable tool in all these venues. Nurses can help people pre disposed to heart disease to stay healthy and treat people with heart disease so that the quality of life for these people becomes better rather then declining into a state where the disease process takes over and eventually ends in death. Overall nurses can educate, prevent and sustain people’s health regarding heart disease. Nurses are cost effective, properly trained and caring enough to get the job done.

INTERVENTION DISADVANTAGES:

Disadvantage A)
Mobile operation centers such as school and office screenings can be set up with correspondence to the American Heart Association (AHA, 2007). These mobile screenings can have a significant impact in catching people pre disposed or those who may have early signs of heart disease but have not yet been diagnosed.

Reason Number 1:
The cost of running and maintaining these mobile operation centers would be to costly to justify their use.

To make this option work well, the city would be required to make an investment to a fleet of vehicles, man power to operate and maintaining those vehicles, man power to work out of those vehicles and screen patients, the cost of supplies, advertising the location of screening clinics and possible paying for temporary housing for the vehicles. According to an article from Children’s Advocate, the cost of running a mobile health center can be over $500,000 in the first year and then $250,000 every year after that to maintain the program. This money would need to come from taxes, fund raisers or private funding which is not practical (Santana, 2005).



Reason Number 2:
Pre screening of patients does not determine that those people at risk or currently living with heart disease will have the motivation or means to seek out regular professional medical help.

The range of people who would be screened in this system is to vague to guarantee that people would follow up with primary care providers or seek out providers if they currently do not receive care. With our current health care system those uninsured would not benefit from this except by gaining some understanding of a disease that they may have. They do not have the insurance or money to seek out routine care to guarantee their future health. Those with insurance or means to seek out care may not follow up with their doctors. We can not be sure that the costs will not out way the benefits. In a research article published in PHN, who screened 222 people for ongoing visits to the mobile centers and follow up exams 3 in 10 people screened did not seek further medical expertise. 8 in 10 of these people could not afford the cost of medical exams, further treatment or transportation to medical facilities (Betty, 1998).

Disavantage B)
Nurse led clinics have been a proven resource in reducing the number of people with heart disease as well as improving the lifestyle of those with heart disease

Reasons number 1:
Nurse led clinics cost more per individual then medical facilities that can meet all of their needs.

The cost of running a nurse lead clinic is astronomical, without MD support the services provided are limited and patients still have to be referred to other medical facilities. Although they may be able to screen and educate they can not do numerous treatments needed to help patients. Patients would much rather be seen in an all encompassing site where all there needs can be met. In a study of 19 nurse led clinics that dissected the willingness of patients to pay for the amount of services rendered for heart disease the cost was (on average) $254 higher in the nurse clinics providing intervention then in just assessing and educating. This extra cost per individual would make it very hard for a nurse led clinic to compete with other medical centers (Campbell, 2005).

Reason number 2:
Nurse led clinics do not have the resources to effectively treat and manage people with heart disease.

Nurse led clinics lack the resources available to treat heart disease patients. They must be referred to treatment centers and hospitals for continuous care. Although nurse led clinics can help educate and prevent heart disease they still lack this essential tool to treat people with heart disease. In my research for this article I found that a majority of clinics that were nurse led failed because of the feeling that they were not giving adequate care to their patients (Campbell, 2005).

References

American Heart Association (AHA). (2007). Exercise and Fitness. Retrieved October.
17, 2007 from http://www.americanheart.org/presenter.jhtml?identifier=1200013

Berg, S., Hertz, P.. (2007). Outpatient Nursing Clinic for Congenital Heart Disease Patients: Copenhagen Transition Program. Journal of Cardiovascular Nursing, 22, 488-492. Retrieved November. 17, 2007 from http://www.jcnjournal.com.

Betty, A., Elnitsky, C. (1998). Rural Mobile Health Units: Outcomes. Public Health Nursing. Vol. 15 (1), 3-11. Retrieved January. 31, 2008 from http://www.blackwell-synergy.com/doi/abs/10.1111/j.1525-1446.1998.tb00314.x?cookieSet=1&journalCode=phn

Campbell, N.C., Murchie, P., Ritchie, L.D., & Thain. J. (2005). Running nurse-led secondary prevention clinics for coronary heart disease in primary clinics: Qualitative study of health professionals’ perspectives. British Journal of General Practice, 55, 522-528. Retrieved April. 12, 2007 from PubMed Central database.

Campbell, N., Murchie, P., Raferty, J. (2005) Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial. BMJ, 707. Retrieved January. 31, 2008 from http://www.bmj.com/cgi/content/full/330/7493/707

National Center for Chronic Disease Prevention and Health Promotion (CDC). (2005). Preventing Heart Disease and Stroke. Retrieved October. 17, 2007 from http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/cvh.htm

Santana, J. (2005). Going Out to the Community, Mobile Clinics Bring Health Care to Families. Childrens Advocate, 12, 96 – 100. Retrieved January. 31, 2008 from http://www.mobilehealthclinicsnetwork.org/featured.html

Wright, J. (2007). Nutritional Spices of Life. Journal of Community Nursing, Vol. 21 (10), 10-16. Retrieved November. 21, 2007 from http://www.jcn.co.uk/index.html


Travis Cox