Optimal management of outpatients with heart failure using advanced practice nurses in a hospital-based heart failure center.
OBJECTIVE
To examine the benefits of an advanced practice nurse (APN) driven, hospital-based heart failure center.


METHODS
Selected multidisciplinary studies, review articles, Heart Failure Society of America practice guidelines, and American College of Cardiology/American Heart Association clinical practice guidelines.


CONCLUSIONS
APN specialists in this hospital-based heart failure center provide heart failure patients with high quality multidisciplinary health care in a single environment, which leads to optimal outcomes. Patients experience positive outcomes as evidenced by spared hospitalizations, improved scores on the Minnesota Living With Heart Failure Survey, and the 6-min walk.


CONCLUSIONS
APNs with prescriptive authority can effectively direct heart failure care for outpatients by utilizing multidisciplinary resources of the hospital. Treatment strategies include titrating medication, frequent symptom monitoring, tracking medication and dietary compliance, telemonitoring, and providing aggressive multidisciplinary education. This approach is highly effective for reducing hospital readmissions as well as for improving quality of life and functional status for outpatients with left ventricular systolic dysfunction.
Crowther
Maryanne
M
Jersey Shore Medical Center, Neptune, New Jersey, USA. Mcrowther@Meridianhealth.com
D002983:Clinical Competence; D006333:Heart Failure / Q000175:diagnosis / Q000451:nursing* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards / Q000706:statistics & numerical data; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000592:standards; D010353:Patient Education as Topic / Q000379:methods; D010359:Patient Readmission; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D014481:United States