Creating New Strategies for Improving Heart Failure Outcomes
LSUHSC/HCSD
LALLIE KEMP MEDICAL CENTER
CONGESTIVE HEART FAILURE PROGRAM
GHIATH MIKDADI, MD WENDY YOUNG, APRN
STATISTICS
Effects 4.8 million persons in US
Costs society $20 billion annually
400,000 to 700,000 diagnosed each year
Hospitalizations increased 155% over the last 20 years
Expected to worsen over next decade
PROGNOSIS
Frequent hospitalizations
Poor quality of life
Increased morbidity
Overall 5 year survival 50%
Less than 25% receive proper medications and education
LA one of lowest ranked states in HF treatment
DIANOSTIC TESTS
Chemistry panel
CBC
Lipids
TSH
B-type naturetic peptide level
CXR, EKG
ECHO/MUGA
TREATMENT
ACE inhibitors/ARB
Beta blockers
Diuretics
HMG Co Reductase Inhibitors
Dietary restrictions
Lifestyle modifications
Patient education, education, education!
GOALS
Early identification of at risk populations
Proper treatment modalities
Treat co-morbid conditions
Decrease hospitalizations/ER visits
Improve quality of life
Reduce morbidity/mortality
LKRMC PROGRESS
Increased referrals to HF clinic
Inpatient & outpatient education program
Smoking cessation program
Improved access to procurement program
Instituted BNP level testing
RESULTS (n=90)
93% on Beta blockers
94% on ACE/ARB
9 hospitalizations
4 ER visits
Improved EF % (10-20%)
PLANS
Update patient database
Promote networking opportunities
Improved control of co-morbid conditions
Discontinuation of offensive medications
Outpatient IV Lasix protocol
Increased community awareness
Participation in Optimize HF Database
PREVENTION
Tight BP control
Aggressive treatment of cholesterol
Optimal care of diabetes
Prevent MI, CAD
Treat underlying causes
Beta blockers in MI survivors regardless of EF
USE WITH CAUTION
Calcium channel blockers
NSAIDS
Tricyclic antidepressants
Muscle relaxants
Thiazolidinediones
Metformin
Staff Members
Tymple Miller, Dietitian
Kerri Ardillo, RN, Utilization Manager
Keri Blanchard, Patient Educator
Ghiath Mikdadi, MD Medical Lead
Jennifer Moran, Statistician
Joan Good, LPN
Wendy Young, APRN Clinical Coordinator
Ancillary staff