Optimal Management of Outpatients With Heart Failure Using Advanced Practice Nurses in a Hospital‐Based Heart Failure Center

PURPOSE: To examine the benefits of an advanced practice nurse (APN) driven, hospital-based heart failure center. DATA SOURCES: Selected multidisciplinary studies, review articles, Heart Failure Society of America practice guidelines, and American College of Cardiology/American Heart Association clinical practice guidelines. CONCLUSIONS: APN specialists in this hospital-based heart failure center provide heart failure patients with high quality multidisciplinary health care in a single environment, which leads to optimal outcomes. Patients experience positive outcomes as evidenced by spared hospitalizations, improved scores on the Minnesota Living With Heart Failure Survey, and the 6-min walk. IMPLICATIONS FOR PRACTICE: APNs with prescriptive authority can effectively direct heart failure care for outpatients by utilizing multidisciplinary resources of the hospital. Treatment strategies include titrating medication, frequent symptom monitoring, tracking medication and dietary compliance, telemonitoring, and providing aggressive multidisciplinary education. This approach is highly effective for reducing hospital readmissions as well as for improving quality of life and functional status for outpatients with left ventricular systolic dysfunction.