心不全の兆候と症状を一貫して評価するためのガイドを臨床実践に実装する
Marilyn A Prasun1, Kelly D Stamp2, Thomas P McCoy3
1Marilyn A. Prasun, PhD, RN, CCNS, CNL, CHFN, FAHA, FAAHFN, Carle BroMenn Medical Center Endowed Professor, Mennonite College of Nursing, Illinois State University, Normal, Illinois.
Background:
Appropriate assessment and assignment of New York Heart Association Functional Classification (NYHA-FC) facilitates management of patients with heart failure (HF).
Purpose:
To evaluate the application of the Consistently Assess Signs and Symptoms of HF (CLASS-HF) Guide in the clinical setting to assign NYHA-FC of patients with HF.
Methods:
A multisite prospective cohort study using a convenience sample of HF providers who care for adult patients with HF was performed. Data were collected before the CLASS-HF Guide implementation and then prospectively for 30 days to examine the NYHA-FC of patients with HF. A survey was then provided for feedback regarding the implementation of the CLASS-HF Guide in clinical practice.
Findings:
A total of 21 HF providers participated. Baseline documentation of NYHA-FC was 75.6%, and after implementation of the CLASS-HF Guide, documentation was 92.1% (an increase of 16.5%, P = .013).
Conclusion:
Application of the CLASS-HF Guide in clinical practice increased NYHA-FC assessment and assignment.
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