The Cardiac Care Bridge Transactional Care Program (CCB) Results and Gaps

Article critique
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Article Critique
Verweij, L., Jepma, P., Buurman, B. M., Latour, C. H. M., Engelbert, R. H. H., Ter Riet, G., ... & op Reimer, W. S. (2018). The cardiac care bridge program: design a randomized trial of nurse-coordinated transitional care in older hospitalized cardiac patients at high risk of readmission and mortality. BMC health services research, 18(1), 1-13. https://doi.org/10.1186/s12913-018-3301-9
Introduction
There is a rise in death and readmission for older patients suffering from cardiac diseases, especially after hospitalization. This has led to the research of how hospitals, particularly physicians and nurses, can develop a plan to curb the increase. The article title is; The cardiac care bridge program; design of a randomized trial of nurse-coordinated transitional care in older hospitalized cardiac patients at high risk of readmission and mortality. Verweij et al. examine the impact of the cardiac care bridge transitional care program that can be used to minimize the impromptu hospital readmission and mortality rate. The article is clear and appropriate and contributes to increasing the nursing knowledge on caring for older patients suffering from cardiac diseases. The Cardiac Care Bridge transactional care program (CCB) incorporates home-based cardiac rehabilitation and case and disease management. It has also discussed three components of care that include hospital, discharge, and post-clinical phase to broaden the research. While this article has produced significant results showing how the CCB program can yield maximum results, gaps still need to be addressed. Lack of recent medical research on the CCB program in nursing further questions the validity of this research. Other conditions such as hospital falls and old age diseases are related to readmission and mortality rate to patients with cardiac disease.
Summary of the Article
Verweij et al. used a sample of 500 patients over the age of seventy in six hospitals with a high risk of mortality and readmission to examine if the CCB program can minimize unplanned hospital mortality and readmission. Patients were given a comprehensive geriatric assessment at admission to participating in the study. It helped in excepting older patients suffering from other conditions. They were also required to fill some questionnaires to collect data. The researchers used the randomized method. They introduced other subsequent measures such as intervention plans that include community-based care nurses, four home visits on post-discharge, physical therapists to perform home-based care, and pharmacists to offer advice on medication. The research has used a randomized design to collect and gather data. It has also stated the study's strengths and limitations and suggestions regarding how to deal with some threats. Verweij et al.'s main aim of the CCB program is to decrease unplanned readmission and mortality in older cardiac patients significantly.
Abstract
The abstract has given a well-articulated summary of what the research entails. There is a brief and simple background on the older patients suffering from cardiac disease. And the overall purpose of the study is indicated. There are also specific points in the abstract that need to be elaborated on further. For example, the authors have mentioned the geriatric conditions that induce risks associated with cardiac disease, subsequent treatment, and management (Verweij et al., 2018). The researchers have included design methodologies such as using a randomized sample, collecting and gathering data, discussing the results, and trial registration date. To collect as much data as possible, patients must be monitored based on three categories: control, intervention, and admission groups. It will also facilitate knowing the challenges faced by patients in each situation.
Research Problems, Research Questions, and Hypotheses
The research problem is how to minimize the readmission and mortality rate of the older population suffering from cardiac disease after hospitalization. It was clearly stated and easy to find. The problem statement builds a persuasive and coherent argument of the study where the researchers studied the effects of implementing the CCB program. The study is significant in nursing as it offers detailed information on the various forms of patients care intervention using the CCB program. But, the researchers failed to state the research questions that could have made it easier for readers to follow. However, they introduced three phases to deal with, thus, had several ideas simultaneously. As a result, readers are unable to understand the whole concept of the study. There were no formal hypotheses present, but statistical tests were used to analyze the data. The population was specified to be an older population of 70 years and above suffering from cardiac diseases and hospitalized. The key variables identified are caring for patients in clinical, discharge, and post-clinical phases.
Review of the Literature
The importance of literature review is to synthesize and summarize the argument and ideas of this study. By building existing knowledge, they help the researcher to engage in their research. The authors failed to include a literature review of their study. There were no major studies on the topic. Thus, it lacked primary sources. They should have incorporated other articles done by several authors on the older patients suffering from cardiac disease, the rate of hospitalization, and mortality, especially after hospitalization. Summarily of sources related to the research could have laid a foundation to conduct the study.
Review of the Theoretical or Conceptual Framework
Verweji et al. have not included a theoretical or conceptual framework of the study. However, they have stated several causes of cardiac disease is the leading cause of mortality and hospitalization. The researchers have induced key concepts to the cause of the problem. For example, the transition of care where a patient is transferred from one environment to another can negatively affect their health due to insufficient care for their health needs(Verweij et al., 2018). Another thing is the impact of geriatric conditions such as cognitive impairment, impaired activities of daily living, and fall risks are also prevalent with cardiac diseases. Poor participation in cardiac rehabilitation programs due to their high intensity is well explained. Possible solutions have been stated, such as enough guidance during hospitalization, transition, and early post-discharge.
Methodology