Evaluating the Efficacy of Focused Nurse Practitioner Visits on Heart Failure Outcomes Among Patients Enrolled in the Program for All-Inclusive Care of the Elderly (PACE): A Quality Improvement Project

Background Heart failure (HF) symptom management is the cornerstone to improving HF related outcomes.1 Rehospitalization rates due to HF sequelae are high and symptom management remains an ongoing issue at PACE. Standardization of physician visits, patient education, and focused Nurse Practitioner (NP) visits to enhance engagement and self-care management of HF will improve outcomes for participants in the PACE program. Purpose The purpose of this quality improvement project was to evaluate the efficacy of focused NP visits on improving HF related outcomes among participants of the PACE program. Conclusions The results for the AHFKT were statistically significant (p = .037) indicating the evidence-based education provided was effective. The self-efficacy and knowledge portion of the KCCQ was the only statistically significant result (p = .047) indicating the education and focused NP visits increased participant knowledge and ability to effectively manage their HF. In evaluation of the symptom severity questions it was determined that participants were more self-aware of their HF symptoms after the HF education, thus providing responses to the KCCQ that showed an inverse relationship. Clinical Implications The result of the AHFKT surmises the education provided was effective which is supported by the results from the KCCQ on knowledge and self-efficacy. The clinical implication for this conclusion supports the evidence-based education booklet as an effective tool in the management of HF when combined with focused NP visits. In terms of sustainability, the education booklet has been adopted by PACE for all HF patients.