1. Description
This is a continuation of the health promotion program
proposal, part one, which you submitted previously. Please
approach this assignment as an opportunity to integrate
instructor feedback from part I and expand on ideas adhering to
the components of the MAP-IT strategy. Include necessary
levels of detail you feel appropriate to assure stakeholder buy-
in.
Directions
For this assignment add criteria 5-8 as detailed below:
5. Propose a health promotion program using an evidence-based
intervention found in your literature search to address the
problem in the selected population/setting. Include a thorough
discussion of the specifics of this intervention which include
resources necessary, those involved, and feasibility for a nurse
in an advanced role. Be certain to include a timeline. ( 3
paragraph. You may use bullets if appropriate).
6. Thoroughly describe the intended outcomes. Describe the
outcomes in detail concurrent with the SMART goal approach.
(1 paragraph).
7. Provide a detailed plan for evaluation for each outcome. (1
paragraph).
8. Thoroughly describe possible barriers/challenges to
implementing the proposed project as well as strategies to
address these barriers/challenges. (1 paragraph).
9. Conclude the paper with a Conclusion paragraph. Don’t type
the word “Conclusion”. Here you will share your insights about
this strategy and your expectations regarding achieving your
goals. (1 paragraph).
Paper Requirements
Your assignment should be 3 pages (excluding title page,
references, and appendices), following APA standards.
Remember, your Proposal must be a scholarly paper

2. demonstrating graduate school level writing and critical
analysis of existing nursing knowledge about health promotion.
Please add this section to the PART 1 ATTACHED , must be
one document for the entire work, AGAIN this 4 pages you will
do now, please add it to the PART 1 ATTACHED, add
references for this section and put them properly in APA style
with the previously in the PART 1.
[removed]
Running head: CONGESTIVE HEART FAILURE
Page 2
Patients with Congestive Heart failure and Increased
Readmission Rates
Florida National University
NGR 6638
Professor Alexander Garcia Salas DNP, MSN, ARNP, FNP-C
Congestive heart failure (CHF), which affects millions of

3. people, especially the elderly, is a significant and expanding
public health concern. According to research, CHF accounts for
between 12 and 15 million office visits and 6.5 million inpatient
days annually (Hollier, 2021). Unfortunately, this approach
leads to disease progression and rehospitalizations for many
CHF patients because of insufficient care, unclear discharge
instructions, and a lack of follow-up visits. These higher
rehospitalization rates are driving up expenses and indicating
that existing care strategies for CHF are not the most effective.
Therefore, evidence-based treatment strategies can lower these
patients' death and readmission rates. These strategies include a
comprehensive discharge plan, educational materials, and
encouraging counseling.
Picot question here
Vulnerable Population
Patients over 65 are the known vulnerable group because it has
been demonstrated that incidence increases with advancing age.
CHF risk factors include hypertension, coronary artery disease,
a recent myocardial infarction, diabetes mellitus, a family
history of cardiovascular disease, alcohol misuse, pregnancy,
sleep apnea, and pollutants (chemotherapy or illicit drugs).
More than 6.5 million people in the United States and more than
26 million people globally are affected by incidence rates,
according to the American Heart Association (AHA). The
ACC/AHA and ESC also advise patient education to encourage
self-care and compliance. In addition, both organizations advise
close supervision to stop adverse outcomes and illness
development, including patient and family surveillance, home
visits, telephone support, and remote monitoring. (Malik, 2022).
According to recommendations, individuals who continue to
develop hyponatremia and show signs of volume overload
despite receiving medical treatment should limit their sodium
intake to 2-3 g/day and their fluid intake to 2 L/day. Patients
also need regular, in-depth education and reassessment to

4. ensure they can follow instructions for the best results.
Review of Literature
Because of sample size constraints in the first literature review,
statistical significance was not attained. For instance, patients
with hypertension, CAD, diabetes, vascular disease, a history of
stroke, and chronic renal disease had more excellent numerical
readmission rates than men, current smokers, or patients
without any of these conditions. No relationship was seen
between better patient self-care practices, understanding of
heart failure, and lower readmission rates (Madanat, 2021).
Therefore, it was necessary to conduct additional analyses of
factors that influence CHF patient admissions, in particular
those elements relating to their care, compliance with treatment
regimens, and disease awareness at home, even though many of
the results regarding comorbid conditions appear to align with
previous study findings. The importance of socioeconomic
determinants in readmission rates was frequently disregarded,
so future attention must be focused on a more thorough patient
approach. As a result, it was impossible to stratify patients
based solely on the probability of readmission. Individualized
patient management and follow-up should have considered
social, demographic, and medical factors.
Another study that was looked at showed how a digital platform
designed to help doctors monitor their CHF patients more
effectively had an impact on their personalized management
monitoring. It showed that these patients saw fewer hospital
readmissions than the other patients who were not using the
platform. With real-time vital statistics and patient health
information outside of the hospital, the advanced technology
database also demonstrated competent care delivery and cost
containment for that group. Finally, the ongoing provision of
care showed a slowing of disease progression. The study,
however, was a 45-day, 62-participant small group study. The
platform allowed users to monitor longitudinal health trends for

5. patient populations and specific patients and information from
their medical records, vital signs, symptoms, and prescription
schedules. Clinicians used a web portal to access the platform.
Along with the patient-generated data, the platform also
displayed patient health data from the electronic medical record
(EMR). (Gjeka, 2021).
Health Promotion
It is encouraging and clear that technology will advance and
become increasingly important in patient health promotion,
especially for seniors with chronic illnesses that need to be
treated by a multidisciplinary team. These patients need
ongoing care as well as follow-up sessions. Unfortunately, most
aged populations face numerous obstacles to effective and
ongoing health promotion. Costs, transportation, cognitive
difficulties, and a lack of family support are a few examples. To
decrease hospital readmissions or morbidity, creating an
individual health promotion program that works with each
patient is crucial.
A theoretical model that can direct efforts for promoting health
is the health belief model. It is employed to anticipate and
justify changes in one's own health-related behavior. One of the
most often used frameworks for understanding health behaviors
is this one. The Health Belief Model (HBM) examines how an
individual perceives the threat posed by a health issue
(susceptibility, severity), the advantages of averting the threat,
and the factors that influence their decision to take action
(barriers, cues to action, and self-efficacy). Therefore, patients
with CHF should refrain from smoking, maintain a healthy
weight, engage in regular aerobic exercise (a minimum of three
days during the week), refrain fromusing illegal substances such
as alcohol and marijuana, and adequately address underlying
comorbidities that cause CHF. In addition, the idea to lower the
incidence of rehospitalizations caused by a dearth of
educational resources, encouraging counseling, and a detailed
discharge plan is best served by using this model as the guiding

6. framework.
References
Gjeka, R. (2021, August 12). Patient engagement with digital
disease management and readmission rates: The case of
congestive heart failure. Retrieved from Sage Journals:
https://journals.sagepub.com/doi/full/10.1177/14604582211030
959
Hollier, A. (2021). Heart failure. In A. Hollier, Clinical
Guidelines in Primary Care (pp. 68–70). Lafayette, LA: APEA.
Madanat, L. (2021). Congestive Heart Failure 30-Day
Readmission: Descriptive Study of Demographics, Co-
morbidities, Heart Failure Knowledge, and Self-Care. NIH, p.
13.
Malik, A. (2022, May 22). Congestive Heart Failure. Retrieved
from NIH: https://www.ncbi.nlm.nih.gov/books/NBK430873/