TAKING A CLOSER LOOK AT HOW TO MANAGE HEART FAILURE PATIENTS IN LONG TERM NURSING CARE FACILITES

1 online resource (51 pages) : PDF

2017

University of North Carolina at Charlotte

Introduction: More than 40% of patients that are admitted to the hospital with HF exacerbations are discharged to LTC facilities. It is estimated that 50% of those patients are hospitalized within 90 days of going to a LTC facility, which may be attributed to most bedside care being provided by LPN/LVN. Research showed that HF patients at LTC facilities have anxiety associated with their diagnosis. The same research showed that the nurses that care for these patients also had increased anxiety and low self-efficacy associated with caring for HF patients. The purpose of this project, was to evaluate the effectiveness of implementing HF clinical guidelines that can be customized, and to evaluate if it affected anxiety of the patients and nurses while increasing the self-efficacy of the nursing staff. Method: Design. This project utilized a quasi-experimental research design. Two LTCs, located in the triad area in North Carolina were the study setting. The sample were heart failure patients and nursing staff at these two facilities. There were 106 patients evaluated, by using a convenience sample. All the patients that were evaluated were older than 65 years old, admitted to the participating facilities, and have a diagnosis of heart failure, but due to the rapidly changing demographics of long term care (LTC) residents and circumstances that the researcher was unable to control, all 106 patients were unable to participate. Generalized Anxiety Disorder (GAD) & and Heart Failure (HF) Self-Efficacy tools were completed by 34 LTC nurses. In-services were given about the HF clinical guidelines. Repeat GAD7 and HF self-efficacy scores were obtained within one month after education on HF guidelines were provided. Results: Findings demonstrate that using clinical guidelines had a significant decrease in nursing anxiety and an increase in HF self-efficacy. These results were obtained by using a paired t-test and confirmed with a Wilcoxon analysis. There was no significant difference in the GAD7 and HF self-efficacy scores of the LPN/LVNs when compared to RNs. Discussion: Finding of this scholarly project supported the use of HF clinical guidelines in LTC facilities. This is demonstrated by the decrease in GAD7 scores and the increase in HF self-efficacy score. The intervention involved providing HF education and empowering the nurses. It is possible that education for the nurses and empowering the nurses had more of an effect on the GAD7 scores and self-efficacy scores than the actual clinical guidelines. Further research is needed on how to implement HF guideline in LTC facilities and how to actively include the resident and their families.

doctoral dissertations

Nursing

D.N.P.

Geriatrics
Heart Failure
Hospitalizations
Long Term Care Facilities

Health Services Research

Troutman-Jordan, Meredith

Whitaker Brown, Charlene
Auffinger, Susan
McGregor, Rob Roy

Thesis (D.N.P.)--University of North Carolina at Charlotte, 2017.

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