THE OUTPATIENT CLINIC FOR PATIENTS WITH HEART FAILURE: A PROPOSAL FOR ADVANCED NURSING

Abstract

Abstract In Italy, Heart Failure represents the leading cause of hospitalization in people over the age of sixty–five and is considered a public health problem of enormous importance, as it entails disabling consequences for the person, such as a significant reduction in the quality of life and the degree of self–sufficiency. Therefore, the person with heart failure requires adequate nursing care in each phase of transition from one care setting to another, as well as in the phase that goes from hospital discharge to the patient‘s return to the home. In the European Guidelines dedicated to Heart Failure it is not specified whether there is a nursing management assistance program dedicated to patients, and if present as it is declined in the various healthcare contexts. The aim of the thesis was to explore in the literature and in the national territory if there are advanced nursing care programs aimed at patients with heart failure and to develop the idea of ​​a nursing–managed clinic, where advanced nursing, which can be introduced into the integrated hospital–community care network for heart failure. For this purpose, a qualitative exploratory survey was developed, divided into two phases: a telephone exploratory survey which considered the cardiological clinics of all the Health Authorities of the Veneto Region and two other Italian Regions; a semi–structured interview addressed to a group of nurses who in the past managed a nursing clinic dedicated to patients with heart failure in a healthcare company in the Veneto Region. The results, especially from the literature review, showed a significant reduction in the risk of hospital readmission and in the mortality rate, an increase in the quality of life. However, differences emerged in the local context regarding the objectives, organization and activity of a Nursing Clinic dedicated to patients with heart failure. The challenge still remains open.