Key result
Advanced practice nurse interventions using a transitional care model for older adults with heart failure require tailored approaches depending on whether the patient has systolic or diastolic failure.
Advanced practice nurse-led transitional care models can be tailored to address the distinct medication and symptom management needs of older adults with systolic versus diastolic heart failure.
May guide tailored APN transitional care in older HF patients; leaves open prospective validation of systolic-diastolic approaches.
Heart failure continues to be a challenge for older patients and their health care providers. This article is based on work by advanced practice nurses in a nursing study funded by the National Institute of Nursing Research of the National Institute of Health. Mary Naylor, RN, PhD at the University of Pennsylvania School of Nursing through grant #1RO1-NR04315 is using a transitional care model to provide advance practice nurse intervention for older adults with heart failure in a randomized controlled trial. Effects of the intervention being addressed include quality of life, functional status, rehospitalizations, and costs of care. Working with the patient in the acute hospital setting and following patients to the home care setting for 3 months, the advance practice nurse develops a visit pattern and intervention plan individual to the patient's needs. Key to a successful intervention plan is the right treatment for systolic versus diastolic failure. Although the patient's symptoms and some physical findings may be similar, the drugs used to treat systolic versus diastolic heart failure are different. Thus the nursing interventions to promote symptom management and avoid rehospitalizations have a different approach. In this article, care of elderly individuals with systolic versus diastolic heart failure is compared and contrasted using physical examination and diagnostic techniques, medication management, and nursing intervention. Case studies of a typical patient with systolic and diastolic heart failure will be used to illustrate the differences in approach to this common group of patients with complex needs.
No takes yet. Share an insight, caveat, or question.
Konick-McMahan et al. (2003) conducted a review in Heart failure. Advance practice nurse intervention was evaluated. Advanced practice nurse interventions using a transitional care model for older adults with heart failure require tailored approaches depending on whether the patient has systolic or diastolic failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: