Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this Internet Enduring Material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of clinical 1.0 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: This session will present the audience with practical strategies to deliver high quality heart failure (HF) care in their nursing home (NH) facilities. HF is three times more prevalent in the NH setting as compared to the outpatient population. It is also the leading cause of hospitalizations and re-hospitalizations among NH residents, pointing to the major burden associated with this chronic illness. Unfortunately, serious gaps exist with respect to evidence-based and patient-centered care of HF management in NHs. There is broad variation among facilities in regards to HF care. Most are unable to consistently provide some of the basic required elements of HF care including daily accurate weights, and low-salt diets. Lack of proactive symptom management and focus on adequate and timely palliation results in inappropriate hospitalizations. This session will provide an overview of the available evidence regarding HF care in this setting and speakers will present strategies for effective management with a special focus on pharmacologic, patient-centered, and palliative approaches to HF care.
Describe the burden of heart failure in the nursing home setting and challenges to effective management.
Explain the gaps in effective heart failure care in nursing homes.
Identify the role of patient-centered outcomes and palliative care in the provision of heart failure care in nursing homes.
Conceive strategies for the provision of effective heart failure care in their own environments.
Speaker(s): Arif Nazir, MD, CMD; William Smucker, MD, CMD
Reference(s): Quinn JR, Pesis-Katz I, Mukamel DB. Variations in patterns of care activities for nursing home residents with heart failure. Res Gerontol Nurs. 2013;6(1):29-35Chen J, Ross JS, Carlson MD, Lin Z, Normand SL, Bernheim SM, et al. Skilled nursing facility referral and hospital readmission rates after heart failure or myocardial infarction. Am J Med. 2012;125(1):100 e1-9Pressler SJ. Heart failure patients in skilled nursing facilities: evidence needed. Circulation Heart failure. 2011;4(3):241-3Jacobs B. Reducing heart failure hospital readmissions from skilled nursing facilities. Prof Case Manag. 2011;16(1):18-24; quiz 5-6. Epub 2010/12/18.Forman DE. Nursing homes and the care of heart failure residents: what have we learned? J Am Med Dir Assoc. 2011;12(8):544. Epub 2011/04/01.Boyde M, Turner C, Thompson DR, Stewart S. Educational interventions for patients with heart failure: a systematic review of randomized controlled trials. The Journal of cardiovascular nursing. 2011;26(4):E27-35. Epub 2010/11/16.Daamen MA, Schols JM, Jaarsma T, Hamers JP. Prevalence of heart failure in nursing homes: a systematic literature review. Scandinavian journal of caring sciences. 2010;24(1):202-8. Epub 2010/01/15.Harrington CC. Assessing heart failure in long-term care facilities. J Gerontol Nurs. 2008;34(2):9-14. Epub 2008/02/22.Mann JL, Evans TS. A review of the management of heart failure in long-term care residents. The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists. 2006;21(3):222-8. Epub 2006/04/01.Albert NM. Evidence-based nursing care for patients with heart failure. AACN advanced critical care. 2006;17(2):170-83)Martinen M, Freundl M. Managing congestive heart failure in long-term care: development of an interdisciplinary protocol. J Gerontol Nurs. 2004;30(12):5-12. Epub 2004/12/31.Aronow WS. Mortality in nursing home patients with congestive heart failure. J Am Med Dir Assoc. 2003;4(4):220-1. Epub 2003/07/12.
MD, CMD, AGSF, FACP,
Chief Medical Officer,