改善心衰预后

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
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!
PROGNOSIS


ຫໍສະໝຸດ Baidu

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
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
Creating New Strategies for Improving Heart Failure Outcomes
LSUHSC/HCSD
LALLIE KEMP MEDICAL CENTER
CONGESTIVE HEART FAILURE PROGRAM
GHIATH MIKDADI, MD WENDY YOUNG, APRN
LKRMC PROGRESS



Increased referrals to HF clinic Inpatient & outpatient education program Smoking cessation program Improved access to procurement program Instituted BNP level testing
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
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
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