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Browsing by Subject "left ventricular assist device"
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Item Implications of Transitional Care Interventions on Hospital Readmissions in Patients With Destination Therapy Left Ventricular Assist Devices(Springer, 2019) Iseler, Jackeline I.; Wierenga, Kelly L.; Shaid, Elizabeth C.; Hirschman, Karen; School of NursingBackground: The rising number of patients with a left ventricular assist device (LVAD) require care management to successfully transition home after implantation. These patients and their families need to manage their heart failure, and the complexities of an LVAD and the associated lifestyle modifications. Translating knowledge of transitional care interventions in patients with chronic diseases to those with an LVAD may provide valuable insight. To help inform the furthering of care transitions in the LVAD patient population, an integrative review was conducted. Aim: The aim of this review was to explore the transitions of care interventions of care in patients and its potential for application in the destination therapy LVAD. Methods: This integrative review was guided by the Whittemore and Knafl's methodology. Results: A total of 12 articles from 264 retrieved articles met inclusion criteria and were included in the literature review. Discussion: This review identified that evidence-based transitional care interventions have been shown to decrease avoidable rehospitalization, the associated costs, and improve quality of life when compared to usual care. Implications for Practice: A common feature of transitional care interventions is the inclusion of nurse leadership. Nurses should be prepared to participate in transitional care interventions to optimally improve outcomes for patients with heart failure and potentially those with an LVAD. Additionally, to make transitional care interventions more effective they should be implemented with moderate intensity or greater. Conclusion: This review provided information supporting the trialing of transitional care interventions in patients with an LVAD and suggests pilot research to optimize interventions for this population.Item Practice Issues for Evaluation and Management of the Suicidal Left Ventricular Assist Device Patient(Sage, 2020-03) Chernyak, Yelena; Teh, Lisa; Henderson, Danielle R.; Patel, Anahli; Psychiatry, School of MedicineThere is a high prevalence of depression among left ventricular assist device patients, who present with an increased risk of suicidality given access to means via the device either with nonadherence or disconnection. Suicidality via device nonadherence/disconnection is an underresearched clinical issue, as paradoxically this life-saving procedure can also provide a method of lethal means to patients with significant mental health concerns. A case study is used to highlight the course of an attempted suicide by ventricular assistive device nonadherence. Clinical implications and recommendations for practice include a thorough psychological evaluation presurgery, monitoring quality of life and coping styles before and after placement, psychological testing, outlining specific suicide protocols, psychiatric care considerations for patients with highly specialized medical devices, and related ethical concerns.