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September 2010, Volume 40 Number 9 , p 12 - 13


  • Cheryl A. Burke MSN, RN, CNS, CPHQ


HEART FAILURE (HF) is an alteration in heart function that results in cardiac output that can't meet the body's demands. More than 5 million people in the United States have HF, and 550,000 new cases are diagnosed each year.1Fifty-four percent of HF readmissions may be preventable.2 HF readmissions are attributed to inadequate discharge planning and patient education, or lack of patient follow-up.2 Lack of adherence to prescribed medication therapy, failure to follow a sodium-restricted diet, and delays in seeking medical attention are among the primary reasons for the high rate of readmission.2This article describes our hospital's efforts to improve our care of patients with HF and reduce our readmission rates by focusing on patient discharge instructions.Major organizations have developed guidelines to address quality care and outcomes for patients with HF. The American College of Cardiology (ACC) and the American Heart Association (AHA), as well as the Heart Failure Society of America, provide practice guidelines for the evaluation and management of patients with HF. The Institute for Healthcare Improvement (IHI) addressed improved care for patients with HF in its 5 Million Lives Campaign.3 The Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC) evaluate performance measures for patients with HF. These core measures of care require that patients receive written instructions or educational materials at discharge that address all components of current evidence-based practice guidelines.2 Meeting CMS compliance requirements includes educating patients about these six elements: * diet * discharge medications * activity level * weight monitoring * what to do if symptoms worsen * follow-up appointments.The ACC/AHA Clinical Performance Measures for Adults with Chronic HF also includes smoking cessation advice and counseling.4 The 2009 Focused Update: ACC Foundation/AHA Guidelines for the Diagnosis and Management of HF in Adults includes

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