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Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 53-60

Effectiveness of a structured heart failure clinical pathway on nurses' knowledge and patient care outcomes

1 College of Nursing, AIIMS, New Delhi, India
2 Department of Cardiology, AIIMS, New Delhi, India

Correspondence Address:
L Gopichandran
Associate Professor, College of Nursing, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcs.jpcs_81_19

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Background: The global burden of heart failure (HF) is affecting at least 26 million people worldwide, and its incidence and prevalence are increasing. Management of patients suffering from HF requires a multidisciplinary management tool which is based on evidence-based practices. A clinical pathway (CP) has emerged as an essential strategy for knowledge transition, which helps in promoting effective health care in all disciplines of health care. The Objectives of the Study: The objectives of the study are to assess the effectiveness of a structured HF CP on nurses' knowledge and patient care outcomes in the Cardiology Department, AIIMS, New Delhi. Materials and Methods: This quasi-experimental study was conducted among 71 nurses working in the cardiac care unit (CCU) and cardiology (CT3) ward and 60 admitted acute decompensated HF patients. The study had three phases: preimplementation phase, implementation phase, and postimplementation phase. The implementation of the structured HF CP was made through an education session for nurses. Results: The nurses' knowledge and the patients' outcomes were assessed and compared before and after implementation of the CP. The knowledge score of the nurses had improved statistically significantly from 11.38 ± 2.9 to 16.85 ± 2.4 (P < 0.0001), after the implementation of the structured HF CP. With regard to patient outcomes, the postimplementation group had significant improvement when compared with the preimplementation group in terms of administration of beta-blockers (P = 0.028) and vaccination (P = 0.037). There was a clinically significant reduction in the length of intensive care unit stay, length of hospital stays, in-hospital mortality, and 30-day readmission and mortality in the postimplementation group than that in the preimplementation group.Conclusion: The implementation of the structured HF CP has improved the knowledge of the nurses working in CCU and CT3 ward and has also enhanced the outcomes of patients admitted in the Cardiology Department, AIIMS, New Delhi.

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