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Heart Failure Pathway

1. Mission

Our mission is not only to improve the quality of life and longevity of heart failure patient but to keep them out of the hospital.

2. Objectives

The Objectives of the clinical pathway for “Heart Failure” are as follows.

  1. To guide the clinical care to all healthcare personnel involved.
  2. To provide evidence based practice guidelines.
  3. Process and outcomes measurement, evaluation and management
  4. To communication among patient,family members,and support services facilitates collaborative practice models as well as patient and family caregiver self management education.

3. Scope

This guideline describes diagnosis and management strategies for adults with heart failure. It focuses primarily on approaches and systems needed to provide appropriate, evidence based care. Heart Failure is a complex syndrome with many new advances in diagnosis and treatment that are summarized in this guideline.

4. Audience

This program has been designed to meet the educational needs of clinicians who care for patients with congestive heart failure with an emphasis on the initial care providers of patients who present for care through the out patient.

5. Definitions

Heart failure is a complex syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the heart to function as a pump to support a physiological circulation. The syndrome of heart failure is characterized by symptom such as breathlessness and fatigue, and signs such as fluid retention.

1. Heart Failure The heart inability to pump an adequate volume of blood to the tissue.
2. NYHA New York Heart Association
3. NYHA function class I Asymptomatic
4. NYHA function class II Symptomatic with moderate exertio
5. NYHA function class III Symptomatic with minimal exertion
6. NYHA function class IV Symptomatic at rest
7. Systolic heart failure The presence of signs and symptoms of heart failure with an ejection fraction of less than 40%
8. Diastolic heart failure The presence of signs and symptoms of heart failure in the absence of systolic dysfunction (Left ventricular ejection fraction > 40%)
9. NTpro BNP N-terminal pro B-type natriuretic peptide

6. Guidelines for health care professionals on the use of Heart Failure Clinical Pathway

Inclusion Criteria

The patient should have diagnosis of:

  • Heart failure, Acute heart failure,Acute decompensate heart failure
  • Pulmonary edema, acute pulmonary edema,Pulmonary congestion
  • Cardiomyopathy,DCM, Ischemic cardiomyopathy, Non Ischemic cardiomyopathy
  • Orthopnea, Paroxysmal nocturnal dyspnea,Fatique, Edema

Exclusion Criteria

  • Patient less than 18 years of age.
  • Patients transferred to another acute care hospital.
  • Patients who expired.
  • Patients who left against medical advic

Needs Immediate Attention

  • Weight gain of 3-5 pounds or more in 1 week.
  • New or increased shortness of breath.
  • Increased swelling of your ankles, feet or abdomen.
  • Decreased urination.
  • Lightheadedness, dizziness, or fainting.
  • Chest pain.
  • Rapid or irregular heratbeats.
  • Coughing or coughing up blood.