Evaluate the research findings published by the Agency for Healthcare Research and Quality (AHRQ) shown in Case Study #1 (Page 90). If you were the administrator of a heath care facility, what actions would you recommend to ensure your facility provides the best of care for your patients?
Support your recommendations with specific details from the research findings.
Refer to ISBN-13 978-0-13-306563-3 Pg. 90
and Case Study 2. If you were care facility, what actions would you recommellU that your facility provides the best of care for your Support your recommendations with specific detai the research findings. patients? ls from Vitamin D Case Study #1 Good Treatments Are Available for People at Risk for Sudden Cardiac Death of nutritio treatment for sudden cardiac death has improved over the ers to prod Deaths from sudden cardiac death can be lovvered by prevent- darker skin ing the specific heart thythm disturbances (ventricular arrhythmias) breast-fed with it. The type I antiarrhythmic drugs (sodium channel blockers) often used in the past are no longer considered helpful. In depend fact, in one study, they were associated with a 21 percent increase in tude, time However, some type Il antiarrhythmic drugs (potassium chan nel blockers), including amiodarone and sotalol, are effective. In a systematic review of methods of preventing sudden cardiac death amiodarone was identified as the most effective medication hong people at risk for sudden cardiac death science, b , decreasing mortality by 13 to 19 percent compared to placebo has expanded markedly. Surgically implanting an ICD to monitor supplement and correct the heart rate can offer additional help. In the same reason a Implantable cardiac defibrillators are effective and their use review of treatments to prevent sudden cardiac death, researchers found that when ICDs were combined with other therapy (most often amiodarone), the ICDs reduced mortality by an additional Case 24 percent. ICDs appeared to be most effective for patients who had an episode of sustained ventricular tachycardia or ventricular fibrillation. The evidence is less strong for patients who had a Discuss earlier myocardial infarction and a low ejection fraction In another study, researchers examined Medicare data for 1987-95 and California hospital discharge data for 1991-95 to study trends in the use and outcomes of ICDs. During the study period, ICD use increased more than tenfold. Mortality rates fell research 6.0 percent to 1.9 percent for the first 30 days after device preventer outcomes were the result of improved efficiency of the device who n another study, it was found that ICD patients had higher over- aeros implantation and from 19.3 percent to 11.4 percent for the year following implantation. It could not be determined whether these bet improved patient selection. Over the study period, the need for ice revision or replacement and overall costs remained stable. all costs than patients treated only with medication because of the upfront costs of the device, but their follow-up costs were lower Quality of life for these patients may be improving. ICDs and antiarrhythmic medications to prevent sudden cardiac death are decreased at first but gradually improved with time. The overall improvements in QOL were greater for patients with ICDs than action crew and i new cases of life-threatening ventricular arrhythmias, QOLdevic using deaths, but their impact on quality of life (OOl) is less clear. In a study that followed 264 patients with or patients treated only with amiodarone. These findings, which Practice
Fundamentals of Health Care Administration