Nurse Driven Education for A Patient Diagnosed With Chronic Systolic Heart Failure Refusing Diagnostic and Interventional Procedures
Wilkes University School of Nursing
Heart failure (HF) is a chronic progressive disease, arising from structural or functional disorders of the heart, in which incidence increases with age. This review attempts to describe the types and causes of HF while focusing on variable aspects of patient education that have a positive effect on patient outcome and quality of life. Specifically, the potential benefits of this education for a 55 year old male patient diagnosed by transthoracic echocardiogram with chronic systolic heart failure, who has refused physician deemed necessary …show more content…
For patients with existing symptoms of heart disease, the nurses role may include helping to identify risk factors and lifestyle habits that have led to the disease, as well as obtaining and documenting vital signs and diagnostic tests used to determine the extent of the disease. Education on identification of significant symptoms and the proper subsequent actions will play a major role in the patient’s ability to advocate for themselves and help them determine when it is necessary to seek care. Nursing responsibilities in caring for a patient already experiencing chronic heart failure, like the one being discussed in this review, include specialized cardiac monitoring, monitoring of vital signs and major organ function, post-procedure care, assessment and care of surgical incisions, administration of medications, managing patient anxiety and compliance, and patient education. Discharge is perhaps the most critical educational opportunity for nurses dealing with HF patients. The level of patient self care and symptom recognition and management after discharge is a significant factor relating to the prevalence of readmittance to the hospital and death in HF patients (Barnason, Zimmerman, and Young, 2011). Barnason, Zimmerman and Young (2011) reveal that one of the factors affecting the compliance with self care actions by heart failure patients is the amount of nurse directed
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Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).
Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).
Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,
When nursing any patient with heart failure it is important to have an understanding of how the heart should work to understand how it stops working correctly. This knowledge is important as writtler (2006) (cited in Jones) feels that district nurses have little knowledge when it comes to heart failure. Patient, Writler (2006) feels that by understanding how the heart works and how it is damaged we, as district nurses will be able to recognise the signs of heart failure earlier7a?.
Providing patients diagnosed with Congestive Heart Failure effective teaching can eliminate reoccurring hospitalizations. Patients are discharged with CHF and readmitted within 30 days. The information provided will examine the process of enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) core measures in relation to Heart Failure (HF) was examined using empirical-based nursing research. Findings suggest that lack of understanding by nurses contributes significantly to the privation of core measure implementation. A significant number of Americans suffer from HF, so patient quality of care assessment was necessitated. Identifying factors were: nurse-patient education resulting in follow-up appointments, left ventricular performance or left ventricular systolic (LVS) function, treatment medications, and smoking cessation programs. Nurses provide an important role in the education of patients with HF. The Nurse is integral in providing documentation in relation to LVS. Nurses play an important role in the administration of HF medication. Smoking, a major cause of HF, requires special nursing intervention. Nursing results in improved quality of care if HF core measures are implemented properly. Additionally, Orem’s universal requisites are fundamental in the nursing process.
A resident at the time saw that although there is a hearty amount of evidence that illustrates that adhering to heart failure guidelines decreases the rate of mortality and morbidity, nationally there is modest adherence to heart failure practice guidelines. Doctors have voiced a multitude of reasons to this poor participation including but not limited to time constraints in a visit, inertia of patterns in practice, lack of awareness and lack of acceptance are a few. This new web-based tool, the “Smart” Heart failure sheet is designed to help connect previously compartmentalized information. It seeks to link guidelines to their patients’ clinical and laboratory characteristics and systematize adherence to heart failure guidelines. It accomplishes this by uploading pertinent patient-specific data, including laboratory and imaging results, procedure reports and relevant medications. Additionally it also provides tools, such as a flow chart for diuretic dosage and weights. Overall this tool is useful to help physicians identify patients who may benefit from a treatment. From there it provides support tools that alert the physician to a personalized medical treatment. The “Smart” Heart Failure Sheet acts as a registry for scholarly research and also provides educational resources to expand providers’ knowledge, thereby improving patient care (Battaglia,
Heart failure (HF) is a debilitating condition that has become a public health problem. There are many debilitating effects of HF for many people that have to live with this disease. According to Hardin and Hussey (2003), recognize inadequate patient education, poor symptom control, and insufficient social support as factors that contribute to preventable HF related hospitalizations (p.p.74). Many people are frequently hospitalized because of HF exacerbation related to lack of knowledge, poor quality of life and medication non adherence. This research proposal determines the effect of Advance Practice Nurse led telephone intervention in the community and how their phone calls would improve the outcomes of patients with Heart Failure. This proposal identifies variables and measurement levels, research methodology and conclusion. The results of the research studies will support the idea that Advanced practice nurses has a positive impact on patients with HF, decreasing HF related hospital admissions and improving their quality of life.
HF is progressively more general situation that results in substantial morbidity, mortality, and use of medical resources, particularly amongst elder Americans (American heart association, 2010). Education plays a key role in preventing frequent readmissions to the hospital. More over adequate knowledge about the disease and social support will improve the living status. It is extremely vital for clients to comprehend and distinguish the alterations in their capacity to uphold standard performance and acquire health care support with any deterioration symptoms. Being submissive with treatment plan and diet are the main features of successful management of
The objectives of heart failure and cardiomyopathy education training are to help patients and their families get the learning, aptitudes, methodologies, critical thinking capacities, and inspiration vital for adherence to the treatment arrangement and support in self-care (American Heart Association, 2011). Moreover, the education will include recognition of signs and symptoms of heart failure, activity and exercise recommendations, compliance with medications, daily weight monitoring, and specific diet
Heart failure is a complex condition that requires multidisciplinary collaboration to assist with symptom management. Heart failure patients need to modify their lifestyles for example, limiting sodium intake, weighing daily and calling the primary care provider with a 2-3 pounds weight
Strategies to educate in reference to the self-care needs of the congestive heart failure patient seems to be common theme in multiple literature reviews. The educational materials may be presented to the patient by the bedside nurse, physician, pharmacy technician, and the nurse or nurse practitioner who is involved with the patient post discharge. It is suggested by one article that the effective impatient measures should include medication review, one hour of heart failure education, adequate discharge planning and communication between the patient, and health care team (McClintock et al., 2014). Once discharge the article suggests that the effective measures include early follow-up, continued education and health management by clinics,
Improving outcomes in heart failure and interdisciplinary approach concentrates on how to live with heart failure. The editors of the book have provided information to those who read the book to have a better quality of life, treatment and effective education for the patient and family. The book entails information for a patient suffering from heart disease to explore other avenues than pharmaceuticals. The main goal of the editors is to educate heart failure patients to be able to manage their disease (Moser and Riegel, 2001).
“According to the American Heart Association (AHA) affects nearly 5.7 million Americans and is responsible for more hospitalizations than all forms of cancer combined. It is the number 1 cause of hospitalization for Medicare patients. With improved survival of patients with acute myocardial infarction and with a population that continues to age, heart failure will continue to increase in prominence as a major health problem in the United States” (Dimitru, 2015,p. Epidemiology). I chose to report on this condition because my grandmother had lived with this condition undiagnosed for many years. I feel that early diagnosis and treatment will lead to better outcomes. With the increasing number of cases each year it is important for the family nurse practitioner to diagnose and treat this chronic condition.