Reflective accounts

Heart failure: part 2

A CPD article improved Anita Skinner’s knowledge of the treatment and management of chronic heart failure.

A CPD article improved Anita Skinner’s knowledge of the treatment and management of chronic heart failure

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What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article was the second of a two-part series on chronic heart failure. It discussed the treatment and management of patients with chronic heart failure, emphasising the importance of improving their quality of life by reducing symptoms and supporting them to self-manage their condition. 

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

I learned that patients with chronic heart failure may experience multiple debilitating symptoms, including breathlessness, fatigue, pain and peripheral oedema, which can significantly affect their physical and psychological well-being.

The article outlined the medicines used to manage the condition, including angiotensin-converting enzyme inhibitors, beta blockers, aldosterone antagonists and diuretics. It stated that diuretics are central to the management of symptomatic acute and chronic heart failure to relieve congestive symptoms, including breathlessness and fluid retention. 

I learned that heart failure guidelines emphasise self-management of the condition, rather than solely focusing on medical management. Therefore, nurses should support patients with the condition to engage in lifestyle modifications, such as exercise, smoking cessation and weight loss. While exercise is the most effective of these interventions, it may not be appropriate for patients who are experiencing breathlessness at rest.

How did you change or improve your practice?

I will ensure that I provide patients with education to improve their understanding of chronic heart failure and the risks associated with non-adherence to their medicines. Providing such education can encourage patients to take their medicines and recognise signs of deterioration, and prevent unnecessary hospital admissions.

I also plan to support patients to self-manage their condition by teaching them how to recognise the signs of oedema and titrate diuretics accordingly, and to monitor their weight daily.

The article stated that depression is common in patients with chronic heart failure and can affect their self-care and adherence to treatment. Therefore, I will ensure that these patients receive regular screenings for depression and are referred to appropriate psychological support services where necessary.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

The information provided in the article about the treatment and management of chronic heart failure will enable nurses to keep their knowledge about the condition up to date, in accordance with the theme of practising effectively. 

The theme of prioritising people states that nurses must promote well-being and prevent ill health. The article assists nurses to promote patients’ well-being by undertaking lifestyle modifications and by recognising the effects that chronic heart failure may have on their mental health and quality of life.

Anita Skinner is a manager at Red House Nursing Home, Kent

This reflective account is based on NS876 Brake R, Jones ID (2017) Chronic heart failure part 2: treatment and management. Nursing Standard. 31, 20, 53-62. 

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