Abstract | BACKGROUND: AIMS: To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM- HFCP), within a General Medical Unit (GMU). METHODS: Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period was conducted. All consecutive patients admitted to GMU at Alfred Hospital, Melbourne with a diagnosis of acute decompensated heart failure were included. Main outcome measures included changes in rates of pharmacologic prescription, non-pharmacologic ward-based management, patient education and action plan provision after intervention. RESULTS: In total, 108 patients were included (median age 84 (inter-quartile range 80-89) years, 47(44%) females). Significant improvements were noted in non-pharmacologic management for patient education regarding fluid restriction (12-30%, P = 0.04), weight monitoring (10-28%, P = 0.03), heart failure action plan on discharge (4-28%, P = 0.002) and salt restriction (6-32%, P = 0.002). The rates of prescription of heart failure medications remained similar between the pre- and post-implementation periods, particularly in patients with reduced ejection fraction by 'appropriateness of prescription' criteria. There were no differences in inpatient mortality or 30-day readmission rates in both groups. CONCLUSIONS: This prospective observational study demonstrated that it is possible to share the roles of a heart failure nurse amongst members of the multidisciplinary team, with similar rates of delivery of pharmacologic and non-pharmacologic management aspects. However, further innovative improvements are needed to address certain aspects of heart failure care.
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Authors | Omar Wahbi-Izzettin, Ingrid Hopper, Edward Ritchie, Vathy Nagalingam, Ar Kar Aung |
Journal | Internal medicine journal
(Intern Med J)
Vol. 48
Issue 2
Pg. 178-183
(02 2018)
ISSN: 1445-5994 [Electronic] Australia |
PMID | 29024333
(Publication Type: Journal Article, Observational Study)
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Copyright | © 2017 Royal Australasian College of Physicians. |
Topics |
- Aged, 80 and over
- Female
- General Practice
(standards, trends)
- Heart Failure
(diagnosis, epidemiology, therapy)
- Hospitals, University
(standards, trends)
- Humans
- Male
- Patient Care Team
(standards, trends)
- Patient Readmission
(standards, trends)
- Pilot Projects
- Prospective Studies
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