Nurse Driven Education for A Patient Diagnosed With Chronic Systolic Heart Failure Refusing Diagnostic and Interventional Procedures
Heather Horsley
Wilkes University School of Nursing
Abstract
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
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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
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,
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.
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.
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,
A literature review of nurse – guided patient –centered heart failure education programs reveal that several studies have recommended strategies to promote improved outcomes for heart failure patients by placing emphasis on education focused on promoting patient self-care management in regards to diet, exercise, weight monitoring, and medication adherence (Baptiste, Mark, Groff-Paris, & Taylor, 2014, p. 53). Heart failure self-care refers to all of the practices in which patients engage to maintain their own health and the decisions that they make about managing signs and symptoms. Hospital initiatives working to improve heart failure readmission rates should implement a patient education program that focuses on self-care. To make it easier to manage the heart failure population at any given time, all patients presenting with heart failure should be admitted to a specific inpatient ward, and daily nursing huddles should be utilized in order to identify heart failure patients. All heart failure patients should be educated by the nursing staff throughout their stay by specialty nurse educators who are themselves educated on heart failure treatments and protocols. The research concluded that implementing standardized patient education programs that focus on self-care management
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
established the clinical problem that heart failure is associated with high morbidity and poor prognosis (Hobbs, et al., 2007). She further added that it decreases patients’ quality of life as it places a heavy burden on them, as well as their families, as well as the huge negative impact on health care resources (Iqbal, et al, 2010), contributing to lost productivity from unplanned hospital admissions. The authors presented the research problem strongly, stating that there is a limited study of the role of specialized heart failure nurses in the multidisciplinary team in managing heart failure patients, thus warranting a further investigation to be conducted. Special nurses, as defined by Glogowska et al, are experienced senior nurses who are involved in providing medical, psychological and emotional support that begins at the initial diagnosis of heart failure and continues onward. They provide transitional care in assisting patients manage their heart failure. The research article focus on the experiences and perceptions of clinicians in managing heart failure patients, and it aims to understand the special role of specialized heart failure nurses in the interdisciplinary team. The authors designed to answer the following questions when conducting this study:
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).
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).
Situation-specific theory of heart failure self-care is the basis for this study. The theory explains that supportive educative – patient can meet self -care requisites, but he /she needs the knowledge to accomplish the task (Riegel, Dickson, & Faulkner, 2016). This theory explained three processes involved in heart failure self-care; The first self-care process is maintenance, it entails behaviors such as treatment adherence. The second self-care process is symptom perception, it involves body listening, monitoring signs, as well as recognition, interpretation, and labeling of symptoms. And the third self-care process, management, is the response to symptoms when they occur (Riegel, et al. 2016). This theory establishes that utilizing of productive
As a carer, if you can attend GP and hospital appointments with the person with heart failure, you can encourage them to ask the right questions while you note down the answers. You could also provide the doctor with additional information or insights into the person’s condition, which can be helpful for planning the right treatment.