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AAHFN Position Paper| Volume 44, ISSUE 2, P173-177, March 2015

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American Association of Heart Failure Nurses Position Paper on Educating Patients with Heart Failure

Published:January 30, 2015DOI:https://doi.org/10.1016/j.hrtlng.2015.01.001
      Heart failure (HF) affects nearly 6 million Americans, a number projected to increase by 46% in the year 2030.
      • Heidenreich P.A.
      • Albert N.M.
      • Allen L.A.
      • et al.
      Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association.
      The diagnosis of HF necessitates that patients and families develop self-care skills and adopt lifestyle changes that facilitate controlling symptoms and slowing the progression of the disorder.
      • Albert N.M.
      Promoting self-care in heart failure: state of clinical practice based on the perspectives of healthcare systems and providers.
      • Riegel B.
      • Lee C.S.
      • Dickson V.V.
      Self care in patients with chronic heart failure.
      These lifestyle changes include: managing a prescribed medication regimen; recognizing signs and symptoms of worsening HF; making dietary changes and adopting an individually tailored exercise program.
      • Albert N.M.
      Promoting self-care in heart failure: state of clinical practice based on the perspectives of healthcare systems and providers.
      • Riegel B.
      • Lee C.S.
      • Dickson V.V.
      Self care in patients with chronic heart failure.
      In order to engage in self-care, persons with HF and their support systems need to acquire knowledge and skills specific to the health problem and the various pharmacologic therapies, devices, and non-pharmacologic interventions that are part of overall HF disease management.
      • Riegel B.
      • Moser D.K.
      • Anker S.D.
      • et al.
      State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association.
      The aim of these efforts is to improve quality of life
      • Goodman H.
      • Firouzi A.
      • Banya W.
      • Lau-Walker M.
      • Cowie M.R.
      Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey.
      and increase survival. Thus, patient and family education is essential to prepare patients with HF for self-care.
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      References

        • Heidenreich P.A.
        • Albert N.M.
        • Allen L.A.
        • et al.
        Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association.
        Circ Heart Fail. 2013; 6: 606-619
        • Albert N.M.
        Promoting self-care in heart failure: state of clinical practice based on the perspectives of healthcare systems and providers.
        J Cardiovasc Nurs. 2008; 23: 277-284
        • Riegel B.
        • Lee C.S.
        • Dickson V.V.
        Self care in patients with chronic heart failure.
        Nat Rev Cardiol. 2011; 8: 644-654
        • Riegel B.
        • Moser D.K.
        • Anker S.D.
        • et al.
        State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association.
        Circulation. 2009; 120: 1141-1163
        • Goodman H.
        • Firouzi A.
        • Banya W.
        • Lau-Walker M.
        • Cowie M.R.
        Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey.
        Int J Nurs Stud. 2013; 50: 945-953
        • The American Nurses Association
        Cardiovascular Nursing: Scope and Standards of Practice.
        ANAnusebook.org, 2008
        • Yancy C.W.
        • Jessup M.
        • Bozkurt B.
        • et al.
        2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.
        Circulation. 2013; 128: 1810-1852
        • Grady K.L.
        • Dracup K.
        • Kennedy G.
        • et al.
        Team management of patients with heart failure: a statement for healthcare professionals from the Cardiovascular Nursing Council of the American Heart Association.
        Circulation. 2000; 102: 2443-2456
        • Lindenfeld J.
        • Albert N.M.
        • Boehmer J.P.
        • et al.
        HFSA 2010 comprehensive heart failure practice guideline.
        J Card Fail. 2010; 16: e1-194
      1. Performance measures for advanced certification in heart failure finalized.
        Jt Comm Perspect. 2013; 33: 11
        • Regalbuto R.
        • Maurer M.S.
        • Chapel D.
        • Mendez J.
        • Shaffer J.A.
        Joint commission requirements for discharge instructions in patients with heart Failure: is understanding important for preventing readmissions?.
        J Card Fail. 2014; 20: 641-649
        • Koelling T.M.
        • Johnson M.L.
        • Cody R.J.
        • Aaronson K.D.
        Discharge education improves clinical outcomes in patients with chronic heart failure.
        Circulation. 2005; 111: 179-185
      2. The next generation of stroke and heart failure care. Joint Commission and American Heart Association/American Stroke Association enhance alliance.
        Jt Comm Perspect. 2011; 31: 11
        • Lee C.S.
        • Greenberg B.H.
        • Laramee A.S.
        • et al.
        HFSA and AAHFN joint position statement: advocating for a full scope of nursing practice and leadership in heart failure.
        J Card Fail. Nov 2012; 18: 811-812
        • Wiggins B.S.
        • Rodgers J.E.
        • DiDomenico R.J.
        • Cook A.M.
        • Page 2nd, R.L.
        Discharge counseling for patients with heart failure or myocardial infarction: a best practices model developed by members of the American College of Clinical Pharmacy's Cardiology Practice and Research Network based on the Hospital to Home (H2H) Initiative.
        Pharmacotherapy. 2013; 33: 558-580
        • Boyde M.
        • Turner C.
        • Thompson D.R.
        • Stewart S.
        Educational interventions for patients with heart failure: a systematic review of randomized controlled trials.
        J Cardiovasc Nurs. 2011; 26: E27-E35
        • Kommuri N.V.
        • Johnson M.L.
        • Koelling T.M.
        Relationship between improvements in heart failure patient disease specific knowledge and clinical events as part of a randomized controlled trial.
        Patient Educ Couns. 2012; 86: 233-238
        • Paul S.
        Hospital discharge education for patients with heart failure: what really works and what is the evidence?.
        Crit Care Nurse. 2008; 28: 66-82
        • Agren S.
        • Evangelista L.S.
        • Hjelm C.
        • Stromberg A.
        Dyads affected by chronic heart failure: a randomized study evaluating effects of education and psychosocial support to patients with heart failure and their partners.
        J Card Fail. 2012; 18: 359-366
        • Dickson V.V.
        • Riegel B.
        Are we teaching what patients need to know? Building skills in heart failure self-care.
        Heart Lung. 2009; 38: 253-261
        • Hibbard J.H.
        • Greene J.
        • Overton V.
        Patients with lower activation associated with higher costs; delivery systems should know their patients' ‘scores’.
        Health Aff (Millwood). 2013; 32: 216-222
        • Lee C.S.
        • Moser D.K.
        • Lennie T.A.
        • Riegel B.
        Event-free survival in adults with heart failure who engage in self-care management.
        Heart Lung. 2011; 40: 12-20
        • Berkowitz S.A.
        • Miller E.D.
        The individual mandate and patient-centered care.
        JAMA. 2011; 306: 648-649
        • Shively M.J.
        • Gardetto N.J.
        • Kodiath M.F.
        • et al.
        Effect of patient activation on self-management in patients with heart failure.
        J Cardiovasc Nurs. 2013; 28: 20-34
        • Mitchell S.E.
        • Gardiner P.M.
        • Sadikova E.
        • et al.
        Patient activation and 30-day post-discharge hospital utilization.
        J Gen Intern Med. 2014; 29: 349-355
        • Baas L.S.
        • Kirkwood P.
        • Lewis C.
        • et al.
        Perceived barriers and facilitators to patients receiving 60 minutes of heart failure education: a survey of AAHFN members.
        Heart Lung. 2014; 43: 3-5
        • Luzinski C.
        The Magnet® model: an infrastructure for excellence.
        J Nurs Adm. 2011; 41: 441-442
        • Smith S.A.
        Magnet hospitals: higher rates of patient satisfaction.
        Policy Polit Nurs Pract. 2014; 15: 30-41
        • Stimpfel A.W.
        • Rosen J.E.
        • McHugh M.D.
        Understanding the role of the professional practice environment on quality of care in Magnet(R) and non-Magnet hospitals.
        J Nurs Adm. 2014; 44: 10-16
        • Heidenreich P.A.
        • Hernandez A.F.
        • Yancy C.W.
        • Liang L.
        • Peterson E.D.
        • Fonarow G.C.
        Get with the Guidelines Program participation, process of care, and outcome for Medicare patients hospitalized with heart failure.
        Circ Cardiovasc Qual Outcomes. 2012; 5: 37-43
        • Harkness K.
        • Spaling M.A.
        • Currie K.
        • Strachan P.H.
        • Clark A.M.
        A systematic review of patient heart failure self-care strategies.
        J Cardiovasc Nurs. 2015; 30: 121-135
        • Falk H.
        • Ekman I.
        • Anderson R.
        • Fu M.
        • Granger B.
        Older patients' experiences of heart failure-an integrative literature review.
        J Nurs Scholarsh. 2013; 45: 247-255
        • Evangelista L.S.
        • Rasmusson K.D.
        • Laramee A.S.
        • et al.
        Health literacy and the patient with heart failure–implications for patient care and research: a consensus statement of the Heart Failure Society of America.
        J Card Fail. 2010; 16: 9-16
        • Bauer L.K.
        • Caro M.A.
        • Beach S.R.
        • et al.
        Effects of depression and anxiety improvement on adherence to medication and health behaviors in recently hospitalized cardiac patients.
        Am J Cardiol. 2012; 109: 1266-1271
        • Johnston D.
        What makes a difference to patients?.
        Int Rev Psychiatry. 2013; 25: 319-328
        • Redeker N.S.
        Sleep disturbance in people with heart failure: implications for self-care.
        J Cardiovasc Nurs. 2008; 23: 231-238
        • Wong C.Y.
        • Chaudhry S.I.
        • Desai M.M.
        • Krumholz H.M.
        Trends in comorbidity, disability, and polypharmacy in heart failure.
        Am J Med. 2011; 124: 136-143
        • Pressler S.J.
        • Subramanian U.
        • Kareken D.
        • et al.
        Cognitive deficits in chronic heart failure.
        Nurs Res. 2010; 59: 127-139
        • Barnason S.
        • Zimmerman L.
        • Young L.
        An integrative review of interventions promoting self-care of patients with heart failure.
        J Clin Nurs. 2012; 21: 448-475
        • Luttik M.L.
        • Jaarsma T.
        • Moser D.
        • Sanderman R.
        • van Veldhuisen D.J.
        The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature.
        J Cardiovasc Nurs. 2005; 20: 162-169
        • Hwang B.
        • Fleischmann K.E.
        • Howie-Esquivel J.
        • Stotts N.A.
        • Dracup K.
        Caregiving for patients with heart failure: impact on patients' families.
        Am J Crit Care. 2011; 20 (quiz 442): 431-441
        • Gallagher R.
        • Luttik M.L.
        • Jaarsma T.
        Social support and self-care in heart failure.
        J Cardiovasc Nurs. 2011; 26: 439-445
        • Fredericks S.
        • Beanlands H.
        • Spalding K.
        • Da Silva M.
        Effects of the characteristics of teaching on the outcomes of heart failure patient education interventions: a systematic review.
        Eur J Cardiovasc Nurs. 2010; 9: 30-37
        • Foster M.V.
        • Sethares K.A.
        Facilitators and barriers to the adoption of telehealth in older adults: an integrative review.
        Comput Inform Nurs. 2014; 32 (quiz 534–5): 523-533
        • Pandor A.
        • Gomersall T.
        • Stevens J.W.
        • et al.
        Remote monitoring after recent hospital discharge in patients with heart failure: a systematic review and network meta-analysis.
        Heart. 2013; 99: 1717-1726
        • Radhakrishnan K.
        • Jacelon C.
        Impact of telehealth on patient self-management of heart failure: a review of literature.
        J Cardiovasc Nurs. 2012; 27: 33-43
        • Boren S.A.
        • Wakefield B.J.
        • Gunlock T.L.
        • Wakefield D.S.
        Heart failure self-management education: a systematic review of the evidence.
        Int J Evid Based Healthc. 2009; 7: 159-168
        • Sales V.L.
        • Ashraf M.S.
        • Lella L.K.
        • et al.
        Utilization of trained volunteers decreases 30-day readmissions for heart failure.
        J Card Fail. 2013; 19: 842-850
        • Jurgens C.Y.
        • Lee C.S.
        • Reitano J.M.
        • Riegel B.
        Heart failure symptom monitoring and response training.
        Heart Lung. 2013; 42: 273-280
        • Jurgens C.Y.
        • Shurpin K.M.
        • Gumersell K.A.
        Challenges and strategies for heart failure symptom management in older adults.
        J Gerontol Nurs. 2010; 36: 24-33
        • Riegel B.
        • Dickson V.V.
        A situation-specific theory of heart failure self-care.
        J Cardiovasc Nurs. 2008; 23: 190-196
        • Riegel B.
        • Lee C.S.
        • Dickson V.V.
        • Carlson B.
        An update on the self-care of heart failure index.
        J Cardiovasc Nurs. 2009; 24: 485-497
        • Hjelm C.
        • Dahl A.
        • Brostrom A.
        • Martensson J.
        • Johansson B.
        • Stromberg A.
        The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older.
        J Clin Nurs. 2012; 21: 994-1003
        • Brodie D.A.
        • Inoue A.
        • Shaw D.G.
        Motivational interviewing to change quality of life for people with chronic heart failure: a randomised controlled trial.
        Int J Nurs Stud. 2008; 45: 489-500
        • Welsh D.
        • Marcinek R.
        • Abshire D.
        • et al.
        Theory-based low-sodium diet education for heart failure patients.
        Home Healthc Nurse. 2010; 28 (quiz 441–433): 432-441
        • McKibbin C.L.
        • Glaser D.
        • Kodiath M.
        • et al.
        Readiness to change in heart failure patients.
        Clin Gerontol. 2007; 31: 33-45
        • Piamjariyakul U.
        • Smith C.E.
        • Russell C.
        • Werkowitch M.
        • Elyachar A.
        The feasibility of a telephone coaching program on heart failure home management for family caregivers.
        Heart Lung. 2013; 42: 32-39
        • Baghianimoghadam M.H.
        • Shogafard G.
        • Sanati H.R.
        • Baghianimoghadam B.
        • Mazloomy S.S.
        • Askarshahi M.
        Application of the health belief model in promotion of self-care in heart failure patients.
        Acta Med Iran. 2013; 51: 52-58
        • Kurylo M.
        • Elliot T.R.
        • DeVivo L.
        • Dreer R.
        Caregiver social problem solving abilities and family member adjustment following congestive heart failure.
        J Clin Psychol Med Settings. 2004; 11: 151-157
        • Strachan P.H.
        • Currie K.
        • Harkness K.
        • Spaling M.
        • Clark A.M.
        Context matters in HF self-care: a qualitative systematic review.
        J Card Fail. 2014 Jun; 20: 448-455
        • Cheng J.W.
        • Nayar M.
        A review of heart failure management in the elderly population.
        Am J Geriatr Pharmacother. 2009; 7: 233-249
        • Dickson V.V.
        • Buck H.
        • Riegel B.
        Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy.
        Nurs Res. 2013; 62: 2-9
        • Goodlin S.J.
        • Wingate S.
        • Albert N.M.
        • et al.
        Investigating pain in heart failure patients: the pain assessment, incidence, and nature in heart failure (PAIN-HF) study.
        J Card Fail. 2012; 18: 776-783
        • Wallenborn J.
        • Angermann C.E.
        Comorbid depression in heart failure.
        Herz. Sep 2013; 38: 587-596
        • Johnson T.J.
        • Basu S.
        • Pisani B.A.
        • et al.
        Depression predicts repeated heart failure hospitalizations.
        J Card Fail. 2012; 18: 246-252
        • Westlake C.
        • Sethares K.
        • Davidson P.
        How can health literacy influence outcomes in heart failure patients? Mechanisms and interventions.
        Curr Heart Fail Rep. 2013; 10: 232-243
        • Peterson P.N.
        • Shetterly S.M.
        • Clarke C.L.
        • et al.
        Health literacy and outcomes among patients with heart failure.
        JAMA. 2011; 305: 1695-1701
        • Cloonan P.
        • Wood J.
        • Riley J.B.
        Reducing 30-day readmissions: health literacy strategies.
        J Nurs Adm. 2013; 43: 382-387
        • Baker D.W.
        • DeWalt D.A.
        • Schillinger D.
        • et al.
        “Teach to goal”: theory and design principles of an intervention to improve heart failure self-management skills of patients with low health literacy.
        J Health Commun. 2011; 16: 73-88
        • Piamjariyakul U.
        • Smith C.E.
        • Werkowitch M.
        • Elyachar A.
        Part 2: enhancing heart failure home management: integrated evidence for a new family caregiver educational plan.
        Appl Nurs Res. 2012; 25: 246-250
        • Shahriari M.
        • Ahmadi M.
        • Babaee S.
        • Mehrabi T.
        • Sadeghi M.
        Effects of a family support program on self-care behaviors in patients with congestive heart failure.
        Iran J Nurs Midwifery Res. 2013; 18: 152-157
        • Graven L.J.
        • Grant J.S.
        Social support and self-care behaviors in individuals with heart failure: an integrative review.
        Int J Nurs Stud. 2014; 51: 320-333
        • Yancy C.W.
        • Abraham W.T.
        • Albert N.M.
        • et al.
        Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry.
        J Am Coll Cardiol. 2008; 51: 1675-1684
        • Chaudhry S.I.
        • Herrin J.
        • Phillips C.
        • et al.
        Racial disparities in health literacy and access to care among patients with heart failure.
        J Card Fail. 2011; 17: 122-127
        • Davidson P.M.
        • Inglis S.C.
        • Newton P.J.
        Self-care in patients with chronic heart failure.
        Expert Rev Pharmacoecon Outcomes Res. 2013; 13: 351-359
        • Riegel B.
        • Moser D.K.
        • Rayens M.K.
        • et al.
        Ethnic differences in quality of life in persons with heart failure.
        J Card Fail. 2008; 14: 41-47
        • Jang Y.
        • Toth J.
        • Yoo H.
        Similarities and differences of self-care behaviors between Korean Americans and Caucasian Americans with heart failure.
        J Transcult Nurs. 2012; 23: 246-254
        • Hopp F.P.
        • Thornton N.
        • Martin L.
        • Zalenski R.
        Life disruption, life continuation: contrasting themes in the lives of African-American elders with advanced heart failure.
        Soc Work Health Care. 2012; 51: 149-172
        • Stamp K.D.
        Women with heart failure: do they require a special approach for improving adherence to self-care?.
        Curr Heart Fail Rep. 2014; 11: 307-313
        • Frankenstein L.
        • Clark A.L.
        • Ribeiro J.P.
        Influence of sex on treatment and outcome in chronic heart failure.
        Cardiovasc Ther. 2012; 30: 182-192
        • White M.L.
        • Schim S.M.
        Development of a spiritual self-care practice scale.
        J Nurs Meas. 2013; 21: 450-462
        • Andrikopoulou E.
        • Abbate K.
        • Whellan D.J.
        Conceptual model for heart failure disease management.
        Can J Cardiol. 2014; 30: 304-311
        • White M.
        • Garbez R.
        • Carroll M.
        • Brinker E.
        • Howie-Esquivel J.
        Is “teach-back” associated with knowledge retention and hospital readmission in hospitalized heart failure patients?.
        J Cardiovasc Nurs. 2013; 28: 137-146
        • Feltner C.
        • Jones C.D.
        • Cene C.W.
        • et al.
        Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis.
        Ann Intern Med. 2014; 160: 774-784
        • Gharacholou S.M.
        • Hellkamp A.S.
        • Hernandez A.F.
        • et al.
        Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: insights from the Get With the Guidelines Program.
        J Card Fail. 2011; 17: 431-439
        • Boxer R.S.
        • Dolansky M.A.
        • Bodnar C.A.
        • Singer M.E.
        • Albert J.M.
        • Gravenstein S.
        A randomized trial of heart failure disease management in skilled nursing facilities: design and rationale.
        J Am Med Dir Assoc. 2013; 14 (e715–711): 710
        • Takeda A.
        • Taylor S.J.
        • Taylor R.S.
        • Khan F.
        • Krum H.
        • Underwood M.
        Clinical service organisation for heart failure.
        Cochrane Database Syst Rev. 2012; 9: CD002752
        • Boyde M.
        • Song S.
        • Peters R.
        • Turner C.
        • Thompson D.R.
        • Stewart S.
        Pilot testing of a self-care education intervention for patients with heart failure.
        Eur J Cardiovasc Nurs. 2013; 12: 39-46
        • Pandor A.
        • Thokala P.
        • Gomersall T.
        • et al.
        Home telemonitoring or structured telephone support programmes after recent discharge in patients with heart failure: systematic review and economic evaluation.
        Health Technol Assess. 2013; 17 (v–vi): 1-207
        • Inglis S.C.
        • Clark R.A.
        • McAlister F.A.
        • Stewart S.
        • Cleland J.G.
        Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review.
        Eur J Heart Fail. 2011; 13: 1028-1040
        • Paul S.
        • Yehle K.S.
        • Wood K.
        • Wingate S.
        • Steg B.
        Implementing shared medical appointments for heart failure patients in a community cardiology practice: a pilot study.
        Heart Lung. 2013; 42: 456-461
        • Frosch D.L.
        • Rincon D.
        • Ochoa S.
        • Mangione C.M.
        Activating seniors to improve chronic disease care: results from a pilot intervention study.
        J Am Geriatr Soc. 2010; 58: 1496-1503
        • Kline K.S.
        • Scott L.D.
        • Britton A.S.
        The use of supportive-educative and mutual goal-setting strategies to improve self-management for patients with heart failure.
        Home Healthc Nurse. 2007; 25: 502-510
        • Hibbard J.H.
        • Greene J.
        What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs.
        Health Aff (Millwood). 2013; 32: 207-214
        • Heydari A.
        • Ahrari S.
        • Vaghee S.
        The relationship between self-concept and adherence to therapeutic regimens in patients with heart failure.
        J Cardiovasc Nurs. 2011; 26: 475-480
        • Cameron J.
        • Worrall-Carter L.
        • Page K.
        • Riegel B.
        • Lo S.K.
        • Stewart S.
        Does cognitive impairment predict poor self-care in patients with heart failure?.
        Eur J Heart Fail. 2010; 12: 508-515
        • Pressler S.J.
        • Therrien B.
        • Riley P.L.
        • et al.
        Nurse-enhanced memory intervention in heart failure: the MEMOIR study.
        J Card Fail. 2011; 17: 832-843
        • Stawnychy M.
        • Masterson Creber R.
        • Riegel B.
        Using brief motivational interviewing to address the complex needs of a challenging patient with heart failure.
        J Cardiovasc Nurs. 2014; 29: E1-E6
        • Riegel B.
        • Dickson V.V.
        • Hoke L.
        • McMahon J.P.
        • Reis B.F.
        • Sayers S.
        A motivational counseling approach to improving heart failure self-care: mechanisms of effectiveness.
        J Cardiovasc Nurs. 2006; 21: 232-241
        • Dunbar S.B.
        • Clark P.C.
        • Reilly C.M.
        • et al.
        A trial of family partnership and education interventions in heart failure.
        J Card Fail. 2013; 19: 829-841
        • Albert N.M.
        Parallel paths to improve heart failure outcomes: evidence matters.
        Am J Crit Care. 2013; 22: 289-296
        • Hebert K.
        • Gogichaishvili I.
        • Gopie S.
        • Arcement L.
        Pathways in heart failure disease management across socioeconomic spectra.
        Crit Pathw Cardiol. 2011; 10: 169-172
        • Jessup M.
        • Albert N.M.
        • Lanfear D.E.
        • et al.
        ACCF/AHA/HFSA 2011 survey results: current staffing profile of heart failure programs, including programs that perform heart transplant and mechanical circulatory support device implantation: a report of the ACCF Heart Failure and Transplant Committee, AHA Heart Failure and Transplantation Committee, and Heart Failure Society of America.
        Circ Heart Fail. 2011; 4: 378-387
        • Ryder M.
        • Beattie J.M.
        • O'Hanlon R.
        • McDonald K.
        Multidisciplinary heart failure management and end of life care.
        Curr Opin Support Palliat Care. 2011; 5: 317-321
        • Washburn S.C.
        • Hornberger C.A.
        Nurse educator guidelines for the management of heart failure.
        J Contin Educ Nurs. 2008; 39: 263-267
        • Jaarsma T.
        • Nikolova-Simons M.
        • van der Wal M.H.
        Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: an in-depth look.
        Heart Lung. 2012; 41: 583-593
        • Mahramus T.L.
        • Penoyer D.A.
        • Sole M.L.
        • Wilson D.
        • Chamberlain L.
        • Warrington W.
        Clinical nurse specialist assessment of nurses' knowledge of heart failure.
        Clin Nurse Spec. 2013; 27: 198-204
        • Mahramus T.
        • Penoyer D.A.
        • Frewin S.
        • Chamberlain L.
        • Wilson D.
        • Sole M.L.
        Assessment of an educational intervention on nurses' knowledge and retention of heart failure self-care principles and the Teach Back method.
        Heart Lung. 2014; 43: 204-212
        • Hart P.L.
        • Spiva L.
        • Kimble L.P.
        Nurses' knowledge of heart failure education principles survey: a psychometric study.
        J Clin Nurs. 2011; 20: 3020-3028
        • Willette E.W.
        • Surrells D.
        • Davis L.L.
        • Bush C.T.
        Nurses' knowledge of heart failure self-management.
        Prog Cardiovasc Nurs. 2007; 22: 190-195
        • Foster C.W.
        Institute of Medicine The Future of Nursing Report, lifelong learning, and certification.
        Medsurg Nurs. 2012; 21: 115-116
        • Altman M.
        Let's get certified: best practices for nurse leaders to create a culture of certification.
        AACN Adv Crit Care. 2011; 22: 68-75
        • Buonocore D.
        • Trupp R.
        • Wingate S.
        American Association of Heart Failure Nurses position paper on the Certified Heart Failure Nurse (CHFN) certification.
        Heart Lung. 2013; 42: 227-228