Heart Failure and Nursing

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 quality of life (QOL) of residents. 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 and a follow-up meeting after 8 months with nurse educators (Oguz, Enc & Yigit, 2010). Added benefits of education would be witnessed as well. Stromberg et al. (2003) discovered that healthcare expenditure and re-hospitalization rates decrease as well when educational interventions including follow-up assistance are employed.

Quality Care

Nursing has a key part to play in heart failure patients' continuous evaluation. These patients' evaluation ought to be grounded in patient needs. Fluid status has normally been evaluated using the following indicators: weight gain, peripheral edema, orthopnea, and a need for increasing baseline diuretic dosage. Furthermore, diet modification, increased thirst, increased consumption of fluids, therapy compliance and decreased activity ought to be evaluated as well, among HF patients. In case of patients who fail to adequately adhere to their medication regimen, careful consultations may be necessary (Pi & Hu, 2016).

Tai Chi, yoga and other traditional exercises are proven to work well in decreasing depression and stress, and in improving physical fitness. These are adjuvant management interventions for HF-diagnosed individuals. Yoga might also prove beneficial in improving patient QOL, preventing retention of fluid, and in regular disease management. Nurses may be able to incorporate yoga in HF patient care (Davidson, 2010). While the nursing profession's significance in educating patients has been understood, no less than one researcher has suggested that 55% of nursing staff members participating in the research devoted a maximum of fifteen minutes to providing relevant patient education on areas such as medications, activity and diet (Pi & Hu, 2016).

Patient Outcomes

Nurses charged with taking care of HF patients are ideally positioned to enhance patient outcomes. Nursing professionals can undertake numerous tasks to enhance HF prognosis. Developing patient education matter in line with practice guidelines to aid aged HF patients constitutes one among the main components ameliorating patient outcomes. A second key nursing task linked to enhancing patient outcomes is assessment. Lastly, nurses may also assist HF-diagnosed individuals by offering patient instructions, participating in QI (quality improvement) initiatives, and putting tele-monitoring initiatives into operation.