Implementation and Testing of Heart Failure Bundle at Ninewells Hospital
This document outlines the strategy for implementing and testing a Heart Failure Bundle in Ward 4 of Ninewells Hospital. The project aims for a 95% compliance rate in ensuring that all appropriate patients receive the necessary elements of the bundle by the end of November 2010. The bundle includes essential assessments, treatments, and preventative measures for patients admitted with heart failure secondary to left ventricular systolic dysfunction (LVSD). The process will involve coordinating with nurses and doctors to record vital patient data and the completion of clinical protocol elements to improve patient care and outcomes.
Implementation and Testing of Heart Failure Bundle at Ninewells Hospital
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Presentation Transcript
Testing a Heart Failure Bundle Professor Allan Struthers
TESTING THE HEART FAILURE BUNDLE IN NINEWELLS HOSPITAL • Implement a Heart Failure Bundle within ward 4 (1) by end of Nov 2010 • Test and implement a Heart Failure Bundle • The appropriate patients have all elements of the bundle completed with 95% compliance
P P P P A A A A D D D D S S S S S S S S D D D D A A A A P P P P A A A A P P P P S S S S D D D D P P P P A A A A D D D D S S S S IMPROVEMENT METHODOLOGY TO TEST AND DEVELOP HEART FAILURE BUNDLE The Bundle Training The Group Spread
DRAFT 1 • HEART FAILURE BUNDLE DATA • To Be Filled in by Nurse • 1. Date of Hospital Admission _______________________ • 2. Date of Ward 4 Admission _______________________ • 3. Date of Ward 4 Discharge _______________________ • DVT Prophylaxis YES / NO • To Be Filled in by Doctor • Expert Review by Consultant • / Registrar in Heart Failure YES / NO • Further investigations CONSIDERED / NOT CONSIDERED • Review of current meds DONE / NOT DONE • Use of diuretics CONSIDERED / NOT CONSIDERED • Devices (CRT, ICD) CONSIDERED / NOT CONSIDERED • Advanced therapies • (LVADs, transplant) CONSIDERED / NOT CONSIDERED • Palliative care CONSIDERED / NOT CONSIDERED • 2. Evidence Based Drugs • ACE inhibitors CONSIDERED / NOT CONSIDERED • Beta Blocker CONSIDERED / NOT CONSIDERED • Spironolactone CONSIDERED / NOT CONSIDERED • ARB CONSIDERED / NOT CONSIDERED
DRAFT 5 HEART FAILURE BUNDLE Complete this document for all patients admitted with a primary diagnosis of heart failure secondary to LVSD confirmed by echocardiogram To Be Completed by Ward Nurse Date of Hospital Admission : ………….…… Date of Ward Admission: …..…..….…… Date of Ward Discharge : …………..….... DVT Prophylaxis YES / NOElement 1 & 2 To Be Completed by Doctor Element 3 to be completed by a Nurse Element 4 to be completed by Specialist Heart Failure Nurse Affixe Patient Label Patient Name………………… DOB/CHI………………………
ELEMENT 4 All elements of bundle have been completedYESNOPlease tick as appropriate
Case Notes ECG Echo UE Patient History/exam Drugs Current ones Diuretics BB/ACEI/Spir CRT Palliative Care HF Nurses CCF Ward Round
CCF Ward RoundHF Bundle ECG CRT/ICD Echo LVSD UE ACEI/Spir History/exam Diuretics Drugs/current Review of meds BB/ACEI/Spir BB/ACEI/Spir CRT CRT/ICD Palliative care Palliative Care HF Nurses HF Nurse
MODEL FOR IMPROVEMENT What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in an improvement? Act Plan Study Do
CHALLENGES • Winter • Roll out to other hospitals
Any Questions?
