title: Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program.
abstract: Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.
authors.affiliation: Susan George, APRN-ACNP, CNS, CHFN, CCRN, CMC, INTEGRIS Advanced Cardiac Care, Oklahoma City. Susan George has been practicing as an advanced practice registered nurse for ten years. Susan has been a heart failure nurse practitioner at INTEGRIS Advanced Cardiac Care Program for approximately eight years. Prior to her career as nurse practitioner, Susan worked at various roles including heart failure clinical nurse specialist, cardiovascular case manager, critical care nurse, and post coronary care nurse. She enjoys working heart failure patients and is passionate about improving outcomes in heart failure patients. A. Renee Leasure, PhD, RN, APRN-CNS, CCRN, is an associate professor in the College of Nursing, University of Oklahoma, Oklahoma City. Dr Leasure also holds an appointment at the Oklahoma City VAMC as a Research Scientist (WOC). She has over thirty-five years experience working with critically and chronically ill adults.
authors.forename: Susan
authors.initials: S
authors.lastname: George
authors.forename: A Renee
authors.initials: AR
authors.lastname: Leasure
mesh_terms: D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D007857:Leadership; D010166:Palliative Care; D011379:Prognosis; D011788:Quality of Life