Volume 38, Issue 5 , Page 363, September 2009
Guidelines for the Care of Heart Failure Patients
Article Outline
Does anybody have a good answer for him?? I sure didn't. There is certainly some very important information in all of these guidelines about interventions we as nurses do for patients with heart failure, for example:
But all of these topics, and almost all other non-pharmacologic-non-device interventions reviewed in these guidelines are labeled as “Level of evidence C”, which means that the evidence comes from very limited populations and includes data from consensus opinion of experts, case studies, or standards of care, not from more rigorous randomized or non-randomized trials or meta-analyses.
This issue was further exemplified in the results of a survey of non-pharmacologic care by heart failure experts.4 Significant variability in practice was noted in the following areas: sodium-restricted diets, alcohol use, sexual activity, increased weight including use of a diuretic regimen, and palliative care. Providers also varied in their treatment of risk factors and comorbid illness, and in their beliefs about patient education and health literacy.
Thus we have limited evidence about many of the interventions we as nurses routinely do for patients, and the actual use of these interventions varies widely among even those providers who identify themselves as experts in the care of heart failure patients.
We owe our patients better than this. AAHFN recognizes the gaps in practice knowledge and will soon be surveying our membership about this and acting on it. Stay tuned.
Sue Wingate RN, PhD, CRNPPresident, AAHFN
References
- 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2009;53:e1–e90
- Executive summary: HFSA 2006 comprehensive heart failure practice guideline. 2006 J Card Fail. 2006;12:10–38
- ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008. European J Heart Fail. 2008;10:933–989
- . Nonpharmacologic care by heart failure experts. J Card Fail. 2006;12:149–153
The Official Journal of the American Association of Heart Failure Nurses
PII: S0147-9563(09)00187-3
doi:10.1016/j.hrtlng.2009.07.009
© 2009 Mosby, Inc. All rights reserved.
Volume 38, Issue 5 , Page 363, September 2009


