The Development and Initial Validation of the LVAD Care Competency Assessment Tool

The availability of an implantable left ventricular assist device (LVAD) has radically transformed the treatment of patients with advanced heart failure (HF). Studies have consistently shown improvements in survival and quality-of-life outcomes among advanced HF patients with LVADs in the past 30 years. However, during this period, much emphasis was placed on outcomes directly influenced by technological advancements and clinical management; the daily care of LVAD (self-management) remains complex and cognitively challenging to patients and their caregivers. Furthermore, preparation for hospital discharge varies across US VAD centers, and there is no objective measure to evaluate patients' and caregivers' self-management competencies. This article describes the development and initial validation of an LVAD Care Competency Assessment Tool (LCCAT)-Observer Form as an objective measure for evaluating patients' and caregivers' readiness for discharge in the context of self-management competencies. A plan for psychometric testing and future studies is outlined, and implications of clinical practice are discussed.