269 - Interprofessional Collaboration between Nursing and Pharmacy to Optimize Inpatient Heart Failure (HF) Education

Abstract

Purpose: As a chronic disease state, heart failure is one of the most common reasons for hospitalizations among patients over the age 65 years. If poorly managed, HF progresses quickly with mortality rates at nearly 50% within 5 years of diagnosis. The annual cost to society is estimated to be over $30 billion each year. We recognized that our patients may not fully understand the medical treatment for this disease state and hence decided to implement an education program in collaboration between nursing and pharmacy to decrease medication illiteracy in this vulnerable population. The focus of our program was on medication education including: indication, side effects, and duration of therapy on newly started medical therapy for inpatients. Objective: To optimize medication education on all hospitalized heart failure patients on a cardiac telemetry unit. Methods: The pilot program began in January of 2012 and has been successful enough to continue to the present time. The program includes having a pharmacy student on their advanced practice (APPE) rotations for bedside consultation from 8am to 12pm Monday through Friday. The counseling is done under the preceptorship of the full time faculty. Pharmacy students review all patient medications and perform a one-on-one medication reconciliation session. They also prepare medication education and perform bedside education with the patient and family (as applicable). The pharmacy student is responsible for identifying any drug-drug or drug-disease interactions, optimization of therapy or adverse reactions. A comprehensive report is provided to the bedside nurse and unit nurse manager on every HF patient who was seen by the student. Any intervention or adverse drug reaction are reported directly to the HF nurse practitioner team and faculty preceptor. Results: To date 63 pharmacy students have provided one-on-one education to HF patients on telemetry unit from January 2012 until July 2016 (4.5 years). The total number of bedside counseling sessions provided was 2089 which resulted in 1178 interventions, 323 reported ADRs and 129 preventable ADR's. The pharmacy students have also provided 46 nursing education presentations on this telemetry unit during the study period. Total number of medications discussed during the study period was 6954, with an average of 3.32 medications/patient. The total number of potential side effects taught were 14,402 (average of 6.1/patient). Average time spent per patient was 24 min which included working up the patient and providing the counseling. Conclusion: Pharmacy bedside consultation services provide patients the opportunity to learn how to manage their disease state by gaining better knowledge and understanding of their medications. This service may help to prevent HF readmissions and helped in establishing a greater nursing—pharmacy relationship. It provided further assistance for the nursing workflow and decreased the amount of time nursing would need to spend on medication education while allowing them to focus on nurse-specific tasks.