Advanced Practice Nurse Strategies to Improve Outcomes and Reduce Cost in Elders with Heart Failure
- 1 October 2006
- journal article
- research article
- Published by Mary Ann Liebert Inc in Disease Management
- Vol. 9 (5), 302-310
- https://doi.org/10.1089/dis.2006.9.302
Abstract
The aim of this study was to investigate whether, in a randomized controlled trial (RCT) of vulnerable elders with heart failure (HF), advanced practice nurses (APNs) who were coordinating care in the transition from hospital to home could improve outcomes, prevent rehospitalizations, and reduce costs when compared with usual care. The APN strategies focused on improving patient and family or caregiver effectiveness in managing their illnesses, strengthening the patient-provider relationship, and managing comorbid conditions while improving overall health. The results were positive. By capitalizing on the patient's desire to achieve their identified goals, APNs successfully educated patients about the meaning of their symptoms and appropriate self-management strategies; improved patient-provider communication patterns; and marshaled caregiver and community resources to maximize patient adherence to the treatment plan and overall quality of life. While HF was the primary reason for enrollment in the study, optimal health outcomes demanded a strong focus on integrating management of comorbid conditions and other long-standing health problems. Specific strategies used by the APN to achieve these positive outcomes are addressed in this report. These strategies are compared with nursing interventions used in other RCTs of HF home management. Directions for future research are explored.Keywords
This publication has 18 references indexed in Scilit:
- Activities of Home-Based Heart Failure Nurse Specialists: A Modified Narrative AnalysisAmerican Journal of Critical Care, 2005
- Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled TrialJournal of the American Geriatrics Society, 2004
- Home-Based Intervention in Congestive Heart FailureCirculation, 2002
- Quality of Life of Individuals With Heart FailureMedical Care, 2002
- Effect of a Standardized Nurse Case-Management Telephone Intervention on Resource Use in Patients With Chronic Heart FailureArchives of Internal Medicine, 2002
- Transitional care of older adults.Annual Review of Nursing Research, 2002
- Effects of education and support on self-care and resource utilization in patients with heart failurePublished by Oxford University Press (OUP) ,1999
- Comprehensive Discharge Planning and Home Follow-up of Hospitalized EldersJAMA, 1999
- A Multidisciplinary Intervention to Prevent the Readmission of Elderly Patients with Congestive Heart FailureNew England Journal of Medicine, 1995
- Comprehensive Discharge Planning for the Hospitalized ElderlyAnnals of Internal Medicine, 1994