NR 585 Week 7 Assignment: Evidence-Based CHF Management Template

Introduction

As a home health nurse, I frequently care for patients diagnosed with Congestive Heart Failure (CHF). Many of these patients lack sufficient understanding of self-management strategies, which significantly impacts their health outcomes. To enhance care quality, it is essential to first assess their baseline knowledge of CHF and then develop individualized interventions. These interventions often include structured education focused on medication adherence, dietary modifications, and symptom monitoring.

CHF is a progressive and chronic condition that develops when the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and peripheral tissues (Cleveland Clinic, 2024). It is one of the primary causes of hospitalization among adults aged 65 and older, with over 6 million Americans currently living with the disease (Cleveland Clinic, 2024). If not properly managed, CHF can shorten life expectancy by nearly a decade. The main contributing risk factors include previous myocardial infarction, coronary artery disease, uncontrolled hypertension, obesity, and diabetes mellitus.

Problem Statement

The clinical problem under investigation is whether daily weight monitoring combined with strict medication adherence can effectively reduce hospital readmissions among CHF patients, as compared to those who neglect daily weight checks and demonstrate poor medication compliance.

Daily weight monitoring serves as an early indicator of fluid retention and potential decompensation, enabling timely medical intervention. Similarly, consistent medication adherence ensures therapeutic stability. When these two behaviors are practiced together, patients become more capable of recognizing early warning signs and engaging healthcare professionals promptly—thus reducing preventable hospital readmissions.

PICOT Question

In CHF patients (P), how do daily weights and medication adherence (I), compared to no daily weights and medication noncompliance (C), affect rehospitalizations (O) within 60 days (T)?

PICOT Breakdown

Research Findings

A review of the current literature reveals several evidence-based strategies that contribute to improved CHF outcomes.

Synthesis

Common Themes

• Nurse-led and interdisciplinary interventions lead to better patient outcomes.

• Daily monitoring and medication adherence are associated with reduced CHF-related hospitalizations.

• Many patients lack adequate knowledge about CHF symptoms, dietary restrictions, and long-term management strategies.

Gaps in Evidence

Overall, evidence strongly supports incorporating daily weight checks and consistent medication adherence into CHF care plans. Educational initiatives that enhance patient understanding and promote self-care behaviors are vital in minimizing hospital readmissions.

Recommendations

Based on the reviewed research, the following recommendations are proposed:

1. Regularly assess patient knowledge using validated questionnaires to identify individual educational needs.

2. Develop personalized care plans that include collaboration among nurses, physicians, dietitians, and social workers.

3. Educate patients about essential self-care practices, including daily weight checks, sodium-restricted diets, fluid monitoring, and early symptom recognition.

4. Encourage participation in patient and caregiver support groups to promote adherence, accountability, and emotional resilience.

NR 585 Week 7 Assignment: Evidence-Based CHF Management Template

Stakeholders

• Patients diagnosed with CHF

• Healthcare providers (nurses, physicians, dietitians, social workers)

• Community networks and family support systems

Resources Needed

References

American Heart Association. (2024). Heart Failure Tools and Resources. https://www.heart.org/en/health-topics/heart-failure/heart-failure-tools-resources

Cleveland Clinic. (2024). Congestive Heart Failure. https://my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heartfailure#management-and-treatment

Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., … Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Journal of the American College of Cardiology, 79(17), e263–e421. https://doi.org/10.1016/j.jacc.2021.12.012

Istianah, I., Said, F. B. M., Nambiar, N., Tohri, T., Ramadhan, M. D., Purwanti, T. F., & Juwita, N. A. (2024). Nursing knowledge and practice in self-care compliance in heart failure patients: A systematic review. International Journal of Nursing, 3(1), 7–15. https://doi.org/10.58418/ijni.v3i1.59

Qiu, X., Lan, C., Li, J., Xiao, X., & Li, J. (2021). The effect of nurse-led interventions on re-admission and mortality for congestive heart failure: A meta-analysis. Medicine, 100(7), e24599. https://doi.org/10.1097/MD.0000000000024599

NR 585 Week 7 Assignment: Evidence-Based CHF Management Template

Ryan, C. J., Bierle, R. S., & Vuckovic, K. M. (2019). The three Rs for preventing heart failure readmission: Review, reassess, and reeducate. Critical Care Nurse, 39(2), 85–93. https://doi.org/10.4037/ccn2019345

Sedlar, N., Lainscak, M., & Farkas, J. (2021). Self-care perception and behaviour in patients with heart failure: A qualitative and quantitative study. ESC Heart Failure, 8(3), 2079–2088. https://doi.org/10.1002/ehf2.13287