Learning about your users- Heart Failure Patients

This past week we formed groups for our semester projects. Gizelle, Janna, and I formed a group and decided to focus on the Heart Failure population, using our knowledge from experiences in cardiac units including in Telemetry, Critical Care Unit, and Cardiac Cath Lab. We hope to answer the question:

How might we improve self-management of Heart Failure patients at home post-discharge?

Heart Failure is one of the leading causes of hospitalization, with about half of those patients being re-admitted within 6 months. If Heart Failure patients are re-admitted within 30 days of their discharge, the hospital is not reimbursed by Centers for Medicare and Medicaid Services (CMS). Frequent admissions can also become a burden on the patient and their family. Patients need to have the proper education about their self-care prior to discharge to help prevent decompensation and re-admission. It is important for patient’s to fully understand and accept the role they will play to manage this chronic condition after discharge.

It is assumed that compliant Heart Failure patients:

-Continue to manage their symptoms at home

-Patients monitor their daily weights

-Check daily vitals signs (BP & HR)

-Patients limit their fluid intake

-Follow a low sodium diet

However with such high rates of re-admission, we wonder what are the reasons that these patients have difficulty managing their care. Possible barriers to self-care include:

-Poor knowledge of disease process

-Lacking skills to manage condition

-Insufficient access to providers

-Lacking social support

-Little motivation to comply with self-care regimen

The average age of a patient admitted with Heart Failure is over the age of 65. We have to keep this in mind, as we look further into our ideas for interventions and the possible use of technology. Barriers of patients using technology include:

-Anxiety

-Low self-efficacy

-Lack of provider support

-Lack of caregiver support

-User-friendliness of technology

Currently working in an acute care area, it is often difficult for patients to retain the education offered to them when they are in such a critical state. When asked if they would like to talk about their condition, they are often too tired or feel overwhelmed with information.

We hope to find a solution to help patients become engaged in learning about their self-management, to have a lasting impact on them, and to motivate them to maintain these lifestyle changes!