APA Summary Table List all Five references/ citations at the bottom of

APA Summary Table

List all Five references/ citations at the bottom of the summary table. Each category will expand down.

PICOT statement: In adult patients, 18 years and older diagnosed with chronic heart failure, admitted to Inova Fairfax Hospital, is adjunctive therapy with medications and lifestyle changes effective in improving cardiac function compared to medication only for six months?


Research question

Study design

Sample size and method

Independent variables and measures

Dependent variables and measures


General strengths

General weakness

The overall quality of study

Summary statement practice


To investigate the effects of chronic heart failure in adults, Its management, and treatment (Real et al., 2018).

Simple random data sampling is used to identify the number of adults included in the study to test the heart failure problem (Real et al., 2018). In addition, the participants received treatment/ diagnosis of the problem from the care team. (Real et al., 2018).

A sample size of 42 adults is considered for the study to develop a constructive report. (Real et. al., 2018). The software was used despite the random method to obtain the sample size system to ensure there is no bias Similar results were identified (Real et. al., 2018). For the adults in critical condition, the care team had their attention and were taken as special cases (Real et al., 2018).

Nice had the guidance for the diagnosis and management of the adults who had the heart failure problem (Real et al., 2018). The independent variable is the treatment and monitoring, interventions and rehabilitation, team working and diagnosis, and information provision to the adults (Real et al., 2018).

The dependent variable in this study is the adults with the heart failure issue (Real et. al., 2018).

People with heart failure conditions had long-term oxygen therapy at home though this is not recommended for the heart failure issue (Real et al., 2018). there were several pieces of advice on treating HF patients; ACE inhabitor, ivabradine, and sacubitril for chronic heart failure (Real et al., 2018).

Under this study, it was best to fit since the sample size for the adults with heart failure was small compared to the young group (Real et al., 2018).

The weakness of this study was identified since the young group was not considered, so differentiating the facial look of the patients was problematic as mostly they used the observation sampling method to obtain the number (Real et al., 2018).

This study showed a positive relationship between the literature provided and the findings on chronic heart failure in adults and their treatment and management (Real et al., 2018).

This study was well conducted and designed to provide evidence for the numbers of adults affected by the chronic heart failure problem as this is a very critical problem among people (Real et al., 2018).


To improve patient outcomes through aiding pharmacological, interventional, and holistic care (Brennan, 2018 ).

This experiment involved the determination of heart failure (Brennan, 2018 ).

The study includes large participants with chronic heart diseases. (Brennan, 2018).

Ethical consent was gained.

Integrated nurse-led chronic HF care management (Brennan, 2018). With the correct treatment and care structures in place, the outcomes and experiences of people living with HF can be improved. Management consists of pharmacological, interventional, and holistic care to ensure optimal treatment (Brennan, 2018 ).

Chronic heart failure nursing care (Brennan, 2018 ).

Experience and training in caring for patients with HF and managing their medications are crucial for health professionals caring for individuals with the condition (Brennan, 2018 ). Hence, HFSNs are generally well placed to initiate and up-titrate patient medications (Brennan, 2018 ).

Drug treatment in HF with reduced ejection fraction is largely based on a combination of medications incrementally titrated up towards the optimum dosage until maximum benefit is achieved (Brennan, 2018 ).

The researchers used a large sample (4740) of participants. (Brennan, 2018). This process may take several months and requires a collaborative effort between the patient and nurse (Brennan, 2018 ).

The researcher advised people with stable chronic HF, regardless of left ventricular ejection fraction (Brennan, 2018 ).

Nurse-led heart failure services help improve patient outcomes through aiding pharmacological, interventional, and holistic care (Brennan, 2018 ).


To investigate the rate of chronic heart failure in adults

Peer-reviewed articles were to be considered for the study to obtain the study’s qualitative and quantitative data. The study mostly stratified the method of sampling considered by the researchers (Chaplin, 2019).

A total of 500 patients who were adults were considered for the study, though a calculation formula was used to obtain the sample size and arrived at n=25, which was very convenient to work with (Chaplin, 2019).

The independent variables are managing heart failure, care planning, and pharmacological management (Chaplin, 2019). These were considered independent variables since they were thus supposed to be influenced by heart failure among adults (Chaplin, 2019).

The dependent variable among this is heart failure among adults (Chaplin, 2019). Heart failure among adults was the most influential thing to be managed by careful planning, pharmacological management, (Chaplin, 2019).

People with heart failure’s illness trajectory is difficult to anticipate, with intervals of stability punctuated by acute deterioration within a steady overall decline (Chaplin, 2019). Patients and health care providers alike may be affected by this, resulting in a lack of effective advance care planning (Chaplin, 2019).

Prognostic technologies have become increasingly popular as a way to detect people who are nearing the end of their lives (Chaplin, 2019). Yet, despite their widespread availability, several prediction technologies remain unproven in the real world

(Chaplin, 2019).

The study population size was large, so with the help of the formula, the sample n made the research easier, and the parties were participative (Chaplin, 2019).

The most discouraging is that many could not trust the report since the sample size was small compared to the large number of adults affected by the problem (Chaplin, 2019).

The findings were correct compared to the kinds of literature (Chaplin, 2019). Moreover, they were positive in that a larger group is affected by heart failure disease but is not taken care of (Chaplin, 2019).

This guideline update provided recommendations for nearly all of the suggested questions because of the presence of adequate, reasonable-quality data.

(Chaplin, 2019). However, many suggestions could not be made due to a lack of current evidence in certain areas (Chaplin, 2019). For example, despite the widespread use of diuretics, no evidence was found comparing intravenous with oral diuretics in treating progressive heart failure (Chaplin, 2019). In addition, further research is needed on the clinical and cost-effectiveness of cardiac magnetic resonance imaging, as no proof has been found thus far (Chaplin, 2019). According to the committee, people with heart failure and atrial fibrillation should not take blockers (Chaplin, 2019). There was a consensus that the retroactive nature of the study was to blame for this discrepancy.


To determine the future directions of heart failure and its management (Choi et al., 2019).

The observation method of study is considered to identify the number of people who have been influenced by the updates on managing heart failure problems (Choi et al., 2019). Different articles are considered so as to obtain information on population size (Choi et al., 2019). Global epidemiology of heart failure is to be considered since it has the exact number (Choi et al., 2019).

A population sample of 39 patients with heart failure problems is considered. Out of this, a random sampling method will be considered where n will be 10. In developed countries, the prevalence of HF ranges from 1 percent to 2 percent, depending on definition and location. People over 70 have a prevalence rate of more than 10 percent (Choi et al., 2019). HFrEF and HFpEF have distinct epidemiological and etiological profiles (Choi et al., 2019).

Patients with HFpEF are older, more female, and more likely to have hypertension and atrial fibrillation (AF) than those with HFrEF (Choi et al., 2019). They also have a lower rate of myocardial infarction (MI) (Choi et al., 2019).

The issue of heart failure and the future directions was considered the independent variable, which is the key influence in the study (Choi et al., 2019).

CT and CMR, strain imaging and novel biomarkers, and genetic testing were more considered as dependent variables since they are the issues the patients have to have been influenced by heart failure management and the directions (Choi et al., 2019).

The results showed that remote monitoring is active in managing heart failure patients, and effects showed that estimates and the use of hemodynamics is best for the management of the treatment (Choi et al., 2019). The articles considered showed encouraging results relating to treating heart failure (Choi et al., 2019).

For this to get, the sample size formula was to be used. Tools and other instruments showed the validity and reliability of the data to be increasing (Choi et al., 2019). The regular mindful problem of heart failure through management was seen in a large number from many articles (Choi et al., 2019).

The results from the data seemed incorrect relating to the small sample, which was considered, so some researchers had doubts.

The study failed to show how local people can manage heart failure; instead, it was narrowly taking deeper into the issues relating to Heart failure management and its directions (Choi et al., 2019).

Aside from the study’s restrictions, examination of the sustainable effects of heart failure management intervention among patients has been happening (Choi et al., 2019). The interferences showed that the rate of management was trending positively (Choi et al., 2019). Furthermore, the study evidenced that in support of managing the HF problem and the directions of the issues in unification with typical health education to patients with the HF problem, a larger group will have helped (Choi et al., 2019).


To evaluate the impacts of managing heart failure on the treatment of chronic heart failure (Koshy et al., 2020).

Peer-reviewed articles are considered to extract the data (Koshy et al., 2020). Scoping review will be undertaken on a protocolized PubMed search to obtain articles relating to chronic heart failure (Koshy et al., 2020).

36 studies were considered for the study to obtain information about heart failure. The people were randomly selected to give information (Koshy et al., 2020).

The Independent variable is heart failure. This was identified from the population size that was present in the sample (Koshy et al., 2020). The method considered in this research was the qualitative research method, as it is based on discussing the complaints of the patients involved in the research to test their heart failure (Koshy et al., 2020 Also, information relating to fatigue, low mood, and dyspnea are considered to obtain the data needed (Koshy et al., 2020

Dependent Variables are exercise intolerance, fatigue, and low mood dyspnea. As for the cough, over 40% of the sample size complained about coughing (Koshy et al., 2020).

Chronic heart failure causes a wide range of symptoms in patients, many of which are under-recognized (Koshy et al., 2020).

Improvements in patient contact can help identify underlying issues and improve clinical management on a systemic level (Koshy et al., 2020). An outpatient clinic setting could benefit greatly from implementing a PRO to track patient and CHF population progress during consultations and treatment.

The researchers used random sampling. Increased confidence in a sample’s ability to accurately represent a population being studied (Koshy et al., 2020).

Despite the small number of the sample considered getting the correct result was not easy, considering that the population size was large ((Koshy et al., 2020).

Intervention or treatment that affects a patient’s outcome can be tested by conducting a research study. For example, chronic heart failure is an issue that is affecting people, and thus, it should be taken care of to help people fight unknown diseases (Koshy et al., 2020).

To back up the study, the most conclusive evidence came from this one. This is a reasonably well-planned and well-executed investigation that yields solid results (Koshy et al., 2020). With minimal risk, the interventions could be used in larger studies of more diverse populations to see if an intervention or treatment affects patient outcomes.

Reference list:

Brennan, E. J. (2018). Chronic heart failure nursing: Integrated multidisciplinary care. British Journal of Nursing, 27(12), 681-688. https://doi.org/10.12968/bjon.2018.27.12.681

Chaplin, S. (2019). Chronic heart failure in adults: Diagnosis and management. Prescriber, 30(1), 16-18. https://doi.org/10.1002/psb.1730

Choi, H. M., Park, M. S., & Youn, J. C. (2019). Update on heart failure management and future directions. The Korean Journal of Internal Medicine, 34(1), 11-43. https://doi.org/10.3904/kjim.2018.428

Koshy, A., Gallivan, E., McGinlay, M., Straw, S., Drozd, M., Toms, A., Gierula, J., Cubbon, R., Kearney, M., & Witte, K. (2020). Prioritizing symptom management in the treatment of chronic heart failure. ESC Heart Failure, 7(5), 2193–2207. https://doi.org/10.1002/ehf2.12875 

Real, J., Cowles, E., & Wierzbicki, A. S. (2018). Chronic heart failure in adults: Summary of updated NICE guidance. BMJ, 362. https://doi.org/10.1136/bmj.k3646