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Shade Akande
CB Medical Inc., USA
Keynote: J Nursing Research and Practice
Background: Despite guideline-driven pharmacological therapies and careful transitional care, the rates of preventable hospital re-admission of heart failure patients and associated costs remain unacceptably high in the Skilled Nursing Facilities (SNF) populations. Transfer to SNF is one strategy to limit hospitalizations. As such, 25% of patients are still symptomatic at time of discharge.
Purpose: The objective of this study is to identify patient factors affecting re-admissions of heart failure patients residing in SNF within 30-days.
Methods: A retrospective electronic chart review was completed on patients >65 years with heart failure who were admitted into large medical center between 2012 and 2014. Descriptive statistics and univariate analyses using the chi-square test or Fisher’s exact test for categorical variables and the Mann-Whitney test for continuous data was used to compare patients readmitted within 30 days vs. those who were not readmitted within 30 days. Significant factors associated with readmission in the univariate analysis (p<0.10) were included for a multivariate logistic regression model.
Results: Fifteen variables: creatinine, weight difference, Chronic Kidney Disease (CKD), Angina, Arrhythmia, Valvular Heart Disease (VHD), Tobacco, ADL, independent in bathing, independent in the toilet, S3 Heart sounds present, HJR, AF, Nitrates, and Hydralazine, were identified for the multivariate logistic regression as potential risk factors associated with “readmission within 30 days”. Creatinine and ADLs were included in the final model as this subset of predictors was found to be the best for prediction of “readmission within 30 days”. Creatinine (p<0.0087) and ADLs (p<0.0077) were both significantly associated with readmission within 30 days in the final logistic regression model. Every 1-unit increase in creatinine is associated with an 87% increase in the odds of being readmitted within 30 days (OR = 1.87). Those patients who require assistance with ADLs are over 9 times more likely to be readmitted within 30 days (OR=9.25) as compared to patients who are independent.
Shade Akande’s philosophy of Nursing is grounded in quality and excellence in nursing practice with specific interest in the field of Cardiomyopathy. Her population of interest being the older adult with heart failure residing in Nursing Homes, in the community, and at Skilled Nursing Facilities. Shade Akande’s wealth of knowledge, educational background both international and here in USA, coupled with evidence-based research will equip me with delivering outstanding care with positive outcome. As PI and co-investigators in NIH funded and multi-center research, she engages in inquiry that may assist with evidence-based practice. she has also engaged in both didactic and clinical teaching to Nurse Practitioner students and as mentors to Doctoral of Nursing Practice (DNP) students. As a clinician, she has the expertise, leadership and motivation to successfully contribute to the mission and values of programs and the institution as a whole. Shade Akande is aware of importance of frequent communication among the project leaders, interdisciplinary team with construction of realistic plan and timeline. She plans to consistently and continually deliver excellent and quality care to the population with increased productivity and positive outcome, to foster unity and dedication to excellence, fostering education and to embrace the concept of continuous performance improvement.
E-mail: fjadesola@aol.com
+44 7915641605
