Improving Heart Failure Disease Management in Skilled Nursing Facilities: Lessons Learned

Mary A. Dolansky, Jeanne A. Hitch, Ileana L. Pina, Rebecca S. Boxer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

Original languageEnglish (US)
Pages (from-to)432-447
Number of pages16
JournalClinical Nursing Research
Volume22
Issue number4
DOIs
StatePublished - Nov 2013

Fingerprint

Skilled Nursing Facilities
Disease Management
Heart Diseases
Heart Failure
Nursing Care
Physicians
Mentoring

Keywords

  • clinical research areas
  • congestive heart failure
  • diseases
  • geriatrics
  • health care settings
  • post acute care setting

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Improving Heart Failure Disease Management in Skilled Nursing Facilities : Lessons Learned. / Dolansky, Mary A.; Hitch, Jeanne A.; Pina, Ileana L.; Boxer, Rebecca S.

In: Clinical Nursing Research, Vol. 22, No. 4, 11.2013, p. 432-447.

Research output: Contribution to journalArticle

Dolansky, Mary A. ; Hitch, Jeanne A. ; Pina, Ileana L. ; Boxer, Rebecca S. / Improving Heart Failure Disease Management in Skilled Nursing Facilities : Lessons Learned. In: Clinical Nursing Research. 2013 ; Vol. 22, No. 4. pp. 432-447.
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