Heart Failure Knowledge among CNAs in a Skilled Nursing Facility: A Pilot Project

Abstract

Background Heart failure (HF) is one of the leading causes of hospitalization among patients over the age of 65 yrs. Many patients with HF are transitioned to skilled nursing facilities (SNF) following hospital discharge for rehabilitation. Limited formal education is currently available to SNF staff on HF treatment and management. Purpose The purpose of this quality improvement pilot project was to develop a sustainable HF educational program specifically for SNF staff to improve their HF knowledge base. This educational intervention focused on the certified nurse aid's (CNA) HF care knowledge through computerized based education and competency demonstration offered during annual competency evaluation. Methods Assessment of perceived knowledge gaps and current available education was reviewed at the SNF. Based on adult learning theory, current literature and ACC/AHA/HFSA guidelines were used to develop computer based educational modules. Module 1 offered basic HF knowledge and an introduction to HF care. Module 2 focused on specific guideline recommended care measures such as, modifying lifestyle choices and completing daily tasks necessary to manage the patient with HF in the SNF environment. The modules were reviewed by a HF expert who offered feedback, and revisions were made. A written 10 question pretest and post-test were developed and given prior and following viewing of the educational modules. Hands on competencies were developed which included, weight assessment, application of compression stockings, volume status monitoring, and low sodium diet recommendations. The educational program was implemented during the annual SNF competency fair. Results Thirty-four of 40 employed CNAs participated in the program. CNA work experience ranged from 6 months to 17 years. Pretest scores ranged from 4 to 10 (M = 7.8, SD 1.4) and post-test scores ranged from 6 to 10 (M = 8.9, SD 1.0) demonstrating a significant improvement in knowledge (p Conclusions HF education is important for all caregivers across the nursing continuum. As HF care continues to transition to SNFs, timely staff education is critically important to ensure optimal patient care and outcomes. Further study is warranted that explores implementation of this educational program in other SNFs and assessment of long-range outcomes.