August 1, 2000
View Full PaperImplementation Strategies to Manage Heart Failure Outcomes
Key Result
Nurse-managed outpatient programs for chronic systolic heart failure should utilize written protocols and consensus guidelines focusing on chronic disease management to improve patient outcomes.
Structured PICO
P
Population
Patients with chronic systolic heart failure in the United States
I
Intervention
Nurse-managed outpatient program for heart failure care using written protocols or algorithms
Nurse-managed outpatient programs utilizing written protocols based on consensus guidelines can help transition heart failure care from episodic to chronic disease management.
Abstract
In the United States, chronic systolic heart failure causes a great economic burden. Pharmacologic and nonpharmacologic therapies must be tailored to the pathophysiologic cause with the ultimate goal of promoting regression or preventing progression of left ventricular remodeling. When this goal is met, symptoms are reduced, quality of life is improved, and morbidity and mortality are decreased. Specific objectives in a nurse-managed heart failure clinic are to improve exercise tolerance, decrease symptoms, and prevent or reduce emergency department visits and acute hospital admissions. Before a nurse-managed outpatient program for heart failure care is implemented, the team must address specific management issues and controversies in heart failure. Actions must focus on chronic disease management rather than just episodic care. Written protocols or algorithms provide guidance in pharmacologic and nonpharmacologic care and ensure that consensus guidelines that offer the best hope of reaching goals are followed.