Abstract 234: Implementation Of A Structured Nurse-led, Patient-centered, Multimedia Education Program To Promote Self-care In Heart Failure Management

Abstract

Objectives: In patients with chronic heart failure (HF), self-care improves the quality of life and prevents hospitalizations. The health confidence 0-10 scoring system is a simple and effective tool to promote patient engagement and adherence to care plans. Our quality improvement initiative incorporates these essential elements into building an effective HF education program. Methods: Patients admitted to the cardiac unit for HF exacerbation at the California Pacific Medical Center were identified using a novel EMR-based algorithm. Each patient was offered 1-on-1 teaching with a nurse educator, video education, printed materials (e.g., interactive self-care workbook), and weight-management supplies (e.g., graduated fluid container, scale). Key teaching topics included HF disease, daily weight, diet, medications, and symptom monitoring. Nurse training videos and checklists were created to ensure standardization and quality of teaching. Patient health confidence score was recorded before and after each in-person and video teaching session. Findings: From October 2020 to February 2022, the average health confidence scores before and after in-person teaching were 4.3 and 7.1, respectively (n=700). HF disease overview and symptom monitoring had the lowest pre-teaching confidence scores among all topics but had the most improvement post-teaching. In some cases, teaching was deferred due to patient refusal (13%) and confusion (5%). Video education was associated with an average improvement of confidence score from 5 to 7.7 (n=65). Conclusions: We have developed a comprehensive HF education pathway that utilizes a novel EMR-based algorithm for early identification of HF patients, standardized training and competency evaluation to assure consistent, high-quality education delivery by the nurses, and multimedia HF education materials to promote HF self-care. Further investigation on the effects of our interventions on HF readmission is underway.