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Get with the guidelines - turning a heart failure nurse into a pulmonary hypertension coordinator.

Ann Schmit

Ashwin Ravichandran

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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1012

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Abstract presented at the 2017 PH Professional Network Symposium held in Bethesda, MD on October 5-7, 2017

Purpose

The guidelines for management of the pulmonary arterial hypertension (PAH) population are relatively new and less well-established, with a much fewer number of providers, as compared to the heart failure population. The objective was to review heart failure guidelines and apply appropriate nursing measures in PAH to increase comfort in providing cost-effective, evidence-based care for this resource intensive population.

Background

Heart failure is a well-researched area of medicine, and nurse involvement in the outpatient setting is extremely important in managing patients’ symptoms and issues, and the application of these concepts of heart failure education can be applied to the PAH patient. Pulmonary hypertension patients, like heart failure patients, are complex and often have multiple health issues and a strong nurse presence helps manage the patient in an outpatient setting and improve outcomes. The management of PAH can be overwhelming for a nurse new to the field. It is important to build upon knowledge and experience to help bridge this gap while also learning new aspects of the role in a continually evolving discipline. To achieve optimal outcomes, the ACCF/AHA Heart Failure guidelines give a class 1 recommendation for patient education to facilitate self-care. Similarly, the ACCF/AHA PH consensus supports educating the PH patient on symptom management, low sodium diet, medication adherence and side effects, remaining active, and encouraging regular contact with the nurse coordinator to allow a shared sense of responsibility.

Methods

Reviews of the 2013 ACCF/AHA Guideline for the Management of Heart Failure and the 2009 ACCF/AHA PH Consensus were completed. The basic tenets and principles of these guidelines were modified to cater toward a PAH specific population.

Results

Guideline based order sets and protocols were developed to streamline efficiency in the multidisciplinary management of these patients and standardize care in the inpatient and outpatient settings.

Conclusion

Nurse involvement in the care of CHF and PAH patient is invaluable. There is considerable overlap in the nursing role as outlined by the ACCF/AHA guidelines for Heart Failure and Pulmonary Hypertension. Highlighting the similarity in nurse education allows for easier transition into the PAH coordinator position.