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STRATEGIES TO IMPROVE SELF-MANAGEMENT IN HEART FAILURE PATIENTS
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As a result of this constructive way to increase communication and collaboration among members of the adult cardiac surgical program, the paediatric cardiac surgical program has initiated a similar group dedicated to the same purpose. Advocating for patients and families is at the heart of what we do and we are better able to do so by enhancing nursing relationships. NP028 STRATEGIES TO IMPROVE SELF-MANAGEMENT IN HEART FAILURE PATIENTS M Toback AHS/FMC, Calgary, AB BACKGROUND:
Heart failure is one of the most common causes of hospitalization, hospital readmission and death. Approximately half of heart failure patients are rehospitalized within 6 months of discharge, and almost two thirds of these patients are readmitted because of a deterioration of a previously diagnosed heart condition. Patients with heart failure are also associated with a complex network of health care providers, for example, multiple coexisting diagnoses which cause polypharmacy, require care from many specialist clinicians’, adjust medications and behavior according to changes in their symptoms, and also maintain a restricted diet and exercise regime. Therefore, the patient plays a crucial role in the management of heart failure disease; however, self-care is a challenge for most heart failure patients without robust and supportive strategies. AIM: To review the available studies on heart failure selfmanagement. Increasing evidence suggests self-management is an important role of educational, behavioral and psychosocial strategies to improve patient outcomes. The results of this study can be used to design the national standards for heart failure self-management education. METHODS: A literature review in PubMed was performed, in the search of the available studies for the period 1999 to 2014. The European Journal of Heart Failure and the up-to-date website were included. CONCLUSION: Improved self-management results in increased compliance, promotes quality of life, improves clinical outcomes, and reduces hospital readmissions thereby decreasing hospitalization costs. NP029 NURSES’ INITIAL PERCEPTIONS OF AN INTERPROFESSIONAL EARLY WARNING SIGNS PROTOCOL FOR PREVENTION OF FAILURE TO RESCUE: PART OF A COLLABORATIVE HOSPITAL-BASED QUALITY IMPROVEMENT PROJECT Y Liu1, V Wrzesien2, M McQuirter1, M Sergerie1 1 McGill University Health Centre, Montréal, QC, 2 Jewish General Hospital, Montréal, QC
Failure to rescue has long been recognized and continues to be an area of concern within the health care system. Accordingly, a university-affiliated hospital network based in Quebec, has
Canadian Journal of Cardiology Volume 30 2014
developed an institutional protocol to act primarily on early signs of patient deterioration and streamlining the response when these signs occur. The goals are preventing in-hospital cardiac arrests, decreasing intensive care admissions, and improving patient outcomes. A quality improvement project was developed to ensure successful implementation practices of the protocol across the institution. The knowledge to action process was used to guide the evaluation of the early warning sign (EWS) protocol implementation. A written survey was conducted with nurses on two medical units as part of this process to evaluate the understanding, acceptance, internalization and impact of the EWS protocol on their practice. A convenience sampling of 37 nurses completed the survey following an educational workshop about EWS. The results suggest that nurses had ambivalent opinions and replied neutrally to statements that addressed the nurse-physician communication and relationship. Concerns regarding staffing and heavy workload, a fear of “crying wolf”, and the cohesiveness between nurse-physician collaboration were voiced as possible limitations. Strengths of this protocol included high rates of agreement among nurses regarding the protocol’s believability, understandability, ease of implementation, buyin and compatibility. For instance, 82.3% of participating nurses agreed that the EWS protocol was compatible with their current practice, knowledge and beliefs. Interventions to increase interprofessional collaboration the EWS protocol are indicated for its successful ongoing deployment across the institution.
NP030 SMOKING CESSATION FOLLOWING DIAGNOSIS OF MILD TO MODERATE CORONARY ARTERY DISEASE R Rana, D Lightburn, L Zavitz St. Paul’s Hospital, Vancouver, BC
Smoking is the single most important modifiable risk factor that one can alter; this is especially crucial for those with cardiovascular disease (CVD). Smoking cessation can be incredibly challenging and typically more than three attempts are necessary before there is successful cessation. Research into smoking cessation in those with CVD has primarily focused on patients following a major cardiac event, such as a myocardial infarction, or revascularization. However, limited research has examined the rate and influencing factors of smoking cessation in outpatients diagnosed with mild to moderate coronary artery disease (CAD) who have not experienced a major cardiac event. These patients do not yet require coronary revascularization, but are treated using medication and secondary prevention, including diet, exercise, and, most importantly, smoking cessation. This study aims to quantify the number of smokers who have not experienced a major cardiac event and have successfully quit smoking within six months of being diagnosed with mild to moderate CAD and to identify factors that influence and hinder success. Following diagnosis, baseline data will be collected through a
As a result of this constructive way to increase communication and collaboration among members of the adult cardiac surgical program, the paediatric cardiac surgical program has initiated a similar group dedicated to the same purpose. Advocating for patients and families is at the heart of what we do and we are better able to do so by enhancing nursing relationships. NP028 STRATEGIES TO IMPROVE SELF-MANAGEMENT IN HEART FAILURE PATIENTS M Toback AHS/FMC, Calgary, AB BACKGROUND:
Heart failure is one of the most common causes of hospitalization, hospital readmission and death. Approximately half of heart failure patients are rehospitalized within 6 months of discharge, and almost two thirds of these patients are readmitted because of a deterioration of a previously diagnosed heart condition. Patients with heart failure are also associated with a complex network of health care providers, for example, multiple coexisting diagnoses which cause polypharmacy, require care from many specialist clinicians’, adjust medications and behavior according to changes in their symptoms, and also maintain a restricted diet and exercise regime. Therefore, the patient plays a crucial role in the management of heart failure disease; however, self-care is a challenge for most heart failure patients without robust and supportive strategies. AIM: To review the available studies on heart failure selfmanagement. Increasing evidence suggests self-management is an important role of educational, behavioral and psychosocial strategies to improve patient outcomes. The results of this study can be used to design the national standards for heart failure self-management education. METHODS: A literature review in PubMed was performed, in the search of the available studies for the period 1999 to 2014. The European Journal of Heart Failure and the up-to-date website were included. CONCLUSION: Improved self-management results in increased compliance, promotes quality of life, improves clinical outcomes, and reduces hospital readmissions thereby decreasing hospitalization costs. NP029 NURSES’ INITIAL PERCEPTIONS OF AN INTERPROFESSIONAL EARLY WARNING SIGNS PROTOCOL FOR PREVENTION OF FAILURE TO RESCUE: PART OF A COLLABORATIVE HOSPITAL-BASED QUALITY IMPROVEMENT PROJECT Y Liu1, V Wrzesien2, M McQuirter1, M Sergerie1 1 McGill University Health Centre, Montréal, QC, 2 Jewish General Hospital, Montréal, QC
Failure to rescue has long been recognized and continues to be an area of concern within the health care system. Accordingly, a university-affiliated hospital network based in Quebec, has
Canadian Journal of Cardiology Volume 30 2014
developed an institutional protocol to act primarily on early signs of patient deterioration and streamlining the response when these signs occur. The goals are preventing in-hospital cardiac arrests, decreasing intensive care admissions, and improving patient outcomes. A quality improvement project was developed to ensure successful implementation practices of the protocol across the institution. The knowledge to action process was used to guide the evaluation of the early warning sign (EWS) protocol implementation. A written survey was conducted with nurses on two medical units as part of this process to evaluate the understanding, acceptance, internalization and impact of the EWS protocol on their practice. A convenience sampling of 37 nurses completed the survey following an educational workshop about EWS. The results suggest that nurses had ambivalent opinions and replied neutrally to statements that addressed the nurse-physician communication and relationship. Concerns regarding staffing and heavy workload, a fear of “crying wolf”, and the cohesiveness between nurse-physician collaboration were voiced as possible limitations. Strengths of this protocol included high rates of agreement among nurses regarding the protocol’s believability, understandability, ease of implementation, buyin and compatibility. For instance, 82.3% of participating nurses agreed that the EWS protocol was compatible with their current practice, knowledge and beliefs. Interventions to increase interprofessional collaboration the EWS protocol are indicated for its successful ongoing deployment across the institution.
NP030 SMOKING CESSATION FOLLOWING DIAGNOSIS OF MILD TO MODERATE CORONARY ARTERY DISEASE R Rana, D Lightburn, L Zavitz St. Paul’s Hospital, Vancouver, BC
Smoking is the single most important modifiable risk factor that one can alter; this is especially crucial for those with cardiovascular disease (CVD). Smoking cessation can be incredibly challenging and typically more than three attempts are necessary before there is successful cessation. Research into smoking cessation in those with CVD has primarily focused on patients following a major cardiac event, such as a myocardial infarction, or revascularization. However, limited research has examined the rate and influencing factors of smoking cessation in outpatients diagnosed with mild to moderate coronary artery disease (CAD) who have not experienced a major cardiac event. These patients do not yet require coronary revascularization, but are treated using medication and secondary prevention, including diet, exercise, and, most importantly, smoking cessation. This study aims to quantify the number of smokers who have not experienced a major cardiac event and have successfully quit smoking within six months of being diagnosed with mild to moderate CAD and to identify factors that influence and hinder success. Following diagnosis, baseline data will be collected through a