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Treatment of Heart Failure in Nursing Home Residents
Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF with LVSD (left ventricular systolic dysfunction) (NCGC, 2010).
In order to treat chronic HF, non-pharmacological as well as pharmacological therapy ought to be utilized for patients. While this condition is quite frequently witnessed among patients living in nursing homes, whether the suggestions put forward in the pharmacological therapy guidelines are implemented within this cluster of patients is unclear (Daamen, et al., 2016).
Issue
Owing to the lack of awareness of the precise prevalence of chronic HF, this phenomenon is often witnessed among aged individuals, whether in nursing homes or outside. To diagnose patients, there is a need to depend on extra examinations besides physical examinations. Hence, there is a risk of making a wrong chronic HF diagnosis or missing a chronic HF diagnosis. Natriuretic peptide assaying is a new diagnostic tool; however, its application is limited to nursing home settings (Barents, Horst, Voors, Hillege, & Jongste, 2008).
Suggestion
Research reveals that more precise diagnoses will stem from a more detailed resident examination for chronic HF. This will successively enhance...
The employment of B-type natriuretic peptide and N-terminal pro b-type natriuretic peptide as added diagnostic tools also holds promise when it comes to nursing home patients; however, this requires further assessment. Prevalence of chronic HF among care-dependent aged individuals was nearly 25%, which is two times as great as that among independent aged individuals (Barents, Horst, Voors, Hillege, & Jongste, 2008).
Initiative
In spite of medical advances, managing HF, a condition that is typically exhibited in the form of a disease syndrome, remains a challenge for medical practitioners. This is evidenced by the fairly greater re-hospitalization rates, combined with increased morbidity and mortality linked to heart failure. With regard to 'in-patient' HF management, the recommendation is to admit patients into intensive care units or telemetry beds (Inamdar & Inamdar, 2016).
HF management and therapy is associated with the long-run objective of avoiding HF aggravation and decreasing re-hospitalization rates. The accomplishment of the above objective incorporates an interdisciplinary strategy that involves patients, doctors, nurses, patient caregivers and families (Inamdar & Inamdar, 2016).
A second intervention that is informed by the self-care model proposed by Orem offers patients self-care related education for facilitating their HF management, in addition to telephone follow-up guidance. Such a self-care behavior improvement is in line with earlier research works in which HF patients' self-care abilities improved after an instructional session…
Bibliography
Barents, M., Horst, V., Voors, A., Hillege, J., & Jongste, M. (2008). Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Neth Heart J., 123 -- 128.
Davidson PM, Cockburn J, Newton PJ, et al. (2010). Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients? Eur J. Cardiovasc Prev Rehabil. 2010;17:393 -- 402
Dinkelaker S. (1999) Can A Nurse-Managed Medication Discharge Planning and Follow-Up Program Affect Readmission Rates of Patients with a Diagnosis of congestive Heart Failure?
Daamen, M., Hamers, J., Gorgels, A., Tan, F., Schols, J., & Rocca, H. (2016). Treatment of heart failure in nursing home residents. J Geriatr Cardiol., 44 -- 50.
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