Produce a comprehensive proposal for a literature review to inform decision making in relation to a nursing activity or intervention

Sample Answer

Literature Review Proposal: Nurse-led Interventions to Reduce Hospital Readmissions in Patients with Chronic Heart Failure

Introduction

The aim of this proposal is to outline a structured and evidence-based plan for a literature review focused on the effectiveness of nurse-led interventions in reducing hospital readmissions for patients with chronic heart failure (CHF). Evidence-Based Practice (EBP) is a core component of nursing and essential for improving patient outcomes and ensuring cost-effective care. This proposal will describe what the literature review will involve, explain why this topic is significant to nursing practice, and outline how the review will be conducted. CHF is a long-term condition that requires ongoing management, and nurses are often at the forefront of this care. By investigating this topic, the review aims to support the development of effective nursing strategies in managing CHF and reducing the pressure on acute services.

Question Formation and Aims of the Review

To guide the literature review, the PICO framework will be used. PICO is suitable for clinical topics and stands for:

• P – Population: Adults diagnosed with chronic heart failure

• I – Intervention: Nurse-led interventions (e.g. home visits, telemonitoring, self-management education)

• C – Comparison: Standard medical care without additional nurse-led input

• O – Outcome: Reduced hospital readmission rates

Using PICO, the research question is:

"How effective are nurse-led interventions compared to standard care in reducing hospital readmissions for adult patients with chronic heart failure?"

The aims of the literature review are:

1. To explore the current evidence on different nurse-led interventions used for patients with CHF.

2. To evaluate whether these interventions are effective in reducing hospital readmission rates.

3. To assess the implications for nursing practice and recommend improvements for future care delivery.

Justification for the Question

Chronic heart failure is a major public health issue in the UK and globally. According to the British Heart Foundation (2023), more than 900,000 people in the UK live with heart failure. It is a leading cause of emergency admissions, particularly in older adults, and hospital readmission rates remain high despite medical advances. The NHS spends a large proportion of its resources on unplanned admissions, and reducing readmission has become a key target in healthcare policy.

Nurses are in a strong position to make a difference in the lives of CHF patients due to their regular contact with them, their ability to build therapeutic relationships, and their role in education and support. Nurse-led care may include structured education about self-management, home monitoring, medication adherence support, and early detection of symptoms. These interventions can potentially prevent deterioration and avoid unnecessary hospital stays.

Ethics

As this proposal is for a literature review, direct contact with patients will not be required. This means patient consent, recruitment and clinical risk are not expected in the same way as primary research. However, ethical issues still need to be considered because the review will use published healthcare evidence.

The review should report evidence honestly and avoid selecting only studies that support one view. All sources should be referenced correctly, and findings should not be exaggerated beyond what the studies show. If patient data is discussed in the selected literature, the review should only use published and anonymised information. This is important because the topic involves adults with chronic heart failure, a condition that often requires long-term monitoring and careful management (NICE, 2025).

Proposed Search Strategy and Criteria for Selection

The proposed review will search nursing and healthcare databases for evidence on nurse-led interventions and hospital readmissions in adults with chronic heart failure. Suitable databases may include CINAHL, MEDLINE, PubMed and the Cochrane Library because they contain nursing, clinical and evidence-based practice research.

Possible search terms include “chronic heart failure”, “heart failure”, “nurse-led intervention”, “nurse-led care”, “patient education”, “telemonitoring”, “discharge planning”, “readmission” and “hospital readmission”. Boolean operators can be used to combine the terms, for example: “heart failure” AND “nurse-led intervention” AND “readmission”.

The review may include peer-reviewed studies, systematic reviews, randomised controlled trials and recent healthcare research focused on adult patients with chronic heart failure. Studies may be excluded if they focus on children, non-nursing interventions, unrelated chronic conditions, opinion-based articles or studies where readmission is not discussed as an outcome. CINAHL is suitable because it indexes nursing and allied health literature, making it relevant for a nursing literature review proposal (EBSCO, 2026).

Strengths and Limitations

A strength of this proposed review is that the topic is closely linked to nursing practice. Nurses are involved in patient education, discharge planning, follow-up care and self-management support, so the findings may be useful for improving care after discharge. Previous reviews have found that nurse-led education and transitional care can reduce heart failure-related readmissions, although results may vary by intervention type and setting (Son et al., 2020; Li et al., 2021).

Another strength is that the review question is focused. It looks at adult patients with chronic heart failure, nurse-led interventions and hospital readmissions. This makes the search more manageable within the word count.

A limitation is that nurse-led interventions may differ between studies. Some may focus on home visits, while others may use telephone follow-up, education sessions or telemonitoring. This can make direct comparison difficult. Another limitation is that readmission rates may be affected by factors outside nursing care, such as disease severity, family support, access to primary care and hospital discharge systems. A recent systematic review also notes that more robust studies are still needed for stronger conclusions about nurse-led heart failure clinics (Wu et al., 2024).

Conclusion

This proposal has outlined a planned literature review on nurse-led interventions for reducing hospital readmissions among adults with chronic heart failure. The topic is relevant to nursing because it connects evidence-based practice with patient education, discharge support and long-term condition management. A focused PICO question, clear search strategy and defined selection criteria can help ensure that the final review is organised and useful for nursing decision making.

Sample References

EBSCO (2026) CINAHL Database. EBSCO Information Services.

Li, M. et al. (2021) ‘Effects of nurse-led transitional care interventions for patients with heart failure on healthcare utilisation: A meta-analysis of randomised controlled trials’, PLOS ONE.

NICE (2025) Chronic heart failure in adults: diagnosis and management. NICE guideline NG106.

Son, Y.J. et al. (2020) ‘Effectiveness of nurse-led heart failure self-care education on health outcomes of heart failure patients: A systematic review and meta-analysis’.

Wu, X. et al. (2024) ‘Effectiveness of nurse-led heart failure clinic: A systematic review’, International Journal of Nursing Sciences, 11(3), pp. 315–329.

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