Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

Managing patients diagnosed with congestive heart failure (CHF) requires coordination with subspecialties and frequent outpatient monitoring. The lack of communication among health care providers and patients can result in a gap in practice when managing patients with CHF in the outpatient setting. Guided by the chronic care model, this quality improvement project was an initiative to develop and implement a 6-week self-care management program provided by nurse practitioners in an outpatient primary care practice. The goal of the project was to improve the day-to-day self-care management of patients with CHF and addressed the practice-focused question of whether a 6-week CHF program offered in the outpatient setting would result in better symptom management due to patients' enhanced adherence to treatment plans. A total of 10 patients participated in the 6-week program, and all participants demonstrated improvement in their CHF symptoms, which allowed them to be reclassified into a lower class on the New York Heart Association's CHF staging system. Of the 10 participants, 7 were completely compliant with attending weekly visits, performing daily journaling, and adhering to dietary recommendations and medication management; 3 participants demonstrated less compliance with the self-care recommendations during the program, but also showed sufficient improvement in symptoms to be reclassified. The project demonstrated the potential for reducing the symptom burden of CHF through proactive outpatient management, contributing to positive social change by improving the quality of life for these patients. Nurse practitioners may find the program description helpful for developing similar initiatives in their clinical settings.

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