Development and Evaluation of a Heart Failure Tool for Homebound Patients

Development and Evaluation of a Clinical Management Protocol for Homebound Congestive Heart Patients by Matthew Kaspar MSN, Thomas Jefferson University, 2011 BSN, Thomas Jefferson University, 2009 MEd, University of Phoenix, 2004 BS, The Ohio State University, 2000 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2016 Abstract With more than 700,000 new diagnoses annually, congestive heart failure (CHF) is a chronic condition that affects the chambers of the heart. When not managed correctly, the disease rapidly progresses to substantial fluid volume overload that impacts activities of daily living and the overall quality of life. The financial implications for poor CHF management cost a mean annual medical expenditure of $33,427 per patient per year.With more than 700,000 new diagnoses annually, congestive heart failure (CHF) is a chronic condition that affects the chambers of the heart. When not managed correctly, the disease rapidly progresses to substantial fluid volume overload that impacts activities of daily living and the overall quality of life. The financial implications for poor CHF management cost a mean annual medical expenditure of $33,427 per patient per year. The need for a diagnostic and prognostic at-home protocol is needed in the medical community, as there is currently no such tool on the market. Donabedian’s framework was used to guide the formulation and interpretation of this research. The purpose of this project was to design a CHF protocol using evidence-based research for clinicians making home visits to homebound patients with a primary diagnosis of CHF with an individualized protocol focusing on disease management, in home support system, knowledge base and financial factors for homebound patients. The protocol was released through a snowballing campaign to clinicians who work with CHF, transitional care, or homecare who then evaluated the protocol on its perceived efficacy if integrated into practice. Findings were analyzed using simple descriptive statistics by 32 nurses and other health care professionals who responded work in home care, cardiology, medical surgical nursing hospitalists, or skilled nursing facilities. Thirty-one of the 32 respondents deemed the protocol useful and stated a clinical need of protocol as evidenced by completed the AGREE II Questionnaire. The findings demonstrate that the CHF Practice Protocol provides clinicians with an evidence-based guidance to manage homebound patients with CHF on a small scale. Development and Evaluation of a Heart Failure Tool for Homebound Patients by Matthew Kaspar MSN, Thomas Jefferson University, 2011 BSN, Thomas Jefferson University, 2009 MEd, University of Phoenix, 2004 BS, The Ohio State University, 2000 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2016