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Successful heart initiatives to keep ticking along

8 May 2006

Successful heart initiatives to keep ticking along

The successful nurse-led heart failure clinics and rehabilitation programme at Tauranga Hospital are to keep ticking along having demonstrated significant achievements.

Cardiac Clinical Nurse Specialist, Wendy Bryson, has been leading two initiatives to improve the quality and length of life of people with heart problems, and keep them well and out of hospital.

The first initiative, a nurse-led clinic, provides a service for people with heart failure to ensure optimal treatment of their condition through increasing doses of specific medications and providing ongoing education.

Readmission rates are sitting at just 9% for people attending clinic due in part to easy and timely access to specialised treatment and knowledge. This is compared to the general readmission rate for heart failure patients of 40%.

Ms Bryson explains that optimal treatment involves sequentially elevating doses of special drugs that help slow the heart rate, lower blood pressure and help the heart muscle to pump more efficiently. Initially, this requires visits to a GP or the nurse-led clinic every two or three weeks, until the optimal medication dosage is achieved for each patient. For most patients this requires around four visits.

"Patients referred to the nurse-led clinic are under the care of the Tauranga Hospital Cardiologists, with their plan of care then being managed by the cardiac specialist nurse, who also provides a link with other patients with heart conditions, and can answer questions and provide specialised support to patients. The clinic provides a cost effective, timely option for patients to achieve and understand the most effective treatment for their heart failure. This together with access to specialist support, are contributing factors to the ongoing success of the clinics," says Ms Bryson.

It is important GPs are fully informed when patients attend the clinics to ensure they are aware of changes in medications and patient progress.

"Once optimal heart failure treatment is achieved, patients are discharged from clinic back to their GPs care, with the understanding that should heart failure symptoms deteriorate, patients can be referred back to clinic," says Ms Bryson.

The second initiative is a heart failure rehabilitation programme, piloted late last year with nine people diagnosed with heart failure, referred to the programme by Tauranga Hospital's Cardiologist.

The eight-week programme focuses on education about the condition, including monitoring of their condition and adhering to treatment and regular exercising.

Sessions include a discussion about what heart failure is, healthy eating, including the need to limit fluid and salt intake, education about what the medications are and why they are so important, and how to live with heart failure.

"The pilot group of nine people found the education, meeting other people with the same problem and encouragement to exercise a huge boost to their understanding and acceptance of their condition. Most recorded significant improvements in quality of life at the end of the programme," says Ms Bryson.

Preassessment includes a six-minute walk test, a quality of life questionnaire, blood pressure and weight monitoring and issuing pedometers! Participants recorded their daily pedometer readings in an exercise diary, with most achieving considerable improvements in activity levels.

The group had a median age of 56, was a balance of Maori and non-Maori, and included several people with severe heart failure and other conditions such as diabetes.

For further information about these initiatives please contact Wendy Bryson on 07 579 8523.

What is heart failure? Heart failure is a chronic condition that occurs when the heart muscle is weakened and has difficulty pumping blood around the body. It requires ongoing medication and lifestyle management for life, or in extreme cases a heart transplant. This is different to a heart attack, which is caused by a blocked artery, which damages the heart muscle.


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