Nurse Practitioner Practice Patterns for Management of Heart Failure in Long-Term Care Facilities

Purpose: This study examined nurse practitioners' (NPs) practice patterns for heart failure (HF) management, specifically regarding the use of angiotensin-converting enzyme inhibitors (ACEIs), beta antagonists, diuretic monotherapy, and echocardiograms for older adults residing in long-term care facilities. Methodology: A Web-based survey was developed to identify NP practice patterns for HF management in long-term care settings. The Checklist for Reporting Results of Internet E-Surveys and expert opinion guided the survey design. The survey was distributed via e-mail to Gerontological Advanced Practice Nurses Association members. Results: Most NPs used ACEIs for ongoing therapy, initiated appropriate therapy for symptomatic patients, continued beta-antagonist therapy in patients with HF, used echocardiograms in the diagnosis and evaluation of HF, and prescribed monotherapy diuretics in accordance with HF care standards. Implications for Practice: Based on these findings, NP practice patterns for management of HF in the long-term care setting are in alignment with national standard of care regardless of certification or level of physician oversight. NPs need to be cognizant of the cardiovascular risk factors for HF and adjust treatment to add an ACEI or beta antagonist to diuretic monotherapy when the clinical diagnosis of HF is suspected or established.