Heart failure guidelines and standards. Throughout the care plan we addressed some of the standards the patients must follow upon discharge due to their diagnosis of heart failure. The most recent heart failure guidelines come from the American College of Cardiology Foundation and the American Heart Association task force on practice guidelines. According to the Journal of the American College of Cardiology (2013):
Experts in the subject under consideration are selected to examine subject-specific data and write guidelines with representatives from other medical organizations and specialty groups. They are asked to perform a literature review; weigh the strength of evidence for or against particular tests, treatments, or procedures; and include estimates of expected outcomes. Patient-specific modifiers, comorbidities, and issues of patient preference that may influence the choice of tests or therapies are considered.
The guidelines set as the standard for all healthcare settings across the nation. The clinic must adhere to these guidelines when developing the discharge education plan as to not assume any legal actions for unethical care and patients’ rights. The clinic must fully address any quality of life issues with the physicians as well so that the patient knows the projected outcomes from the beginning. “The increasing ability of medicine to keep patients with advanced heart failure alive for years raises the debate about the tradeoff between quality of life and quantity of years of life” (Fields & Kirkpatrick, 2012). The heart failure clinic should consult with a medical ethics committee throughout the entire process of starting the clinic and admitting patients into the program.
Evaluation and conclusion. As previously stated, meeting the goals of the clinic will evaluate the success of the heart failure clinic discharge program. Patients will be enrolled in the program and complete a pre-test of knowledge at that time, known as the Dutch Heart Failure Knowledge Scale (DHFKS). “This 15-item multiple choice questionnaire has been found to be a valid and reliable instrument to measure patients’ knowledge of symptoms related to CHF, medication compliance, diet, fluid allowance, and physical activity” (Boyde et al, 2013). The same questionnaire will be given 6 months post their discharge date. Afterwards the staff will use the statistics of the pre and post-test answers to assess for success as well. Another way to possibly evaluate the success of the program is using pre and post lab work to compare certain levels.
The success of the program relies heavily on everyone in the care teams abilities to work together to improve the quality of life in these patients and reduce the readmission rates to the hospital in regards to heart failure.