More help for heart patients

Education helps to improve quality of life for chronic heart failure patients

CHRONIC heart failure patients in Highland are enjoying a better quality of life for longer, thanks to the work of the Heart Failure Service, which is run jointly by NHS Highland and British Heart Foundation (BHF) Scotland.
The service was set up to help support chronic heart failure patients and their carers by introducing them to self management aspects of care, which allows them to live with this longterm condition.
The team of five heart failure nurses are busy educating other staff members on heart failure management to allow a more consistent flow of support and management.
They are currently working with GPs and nurses in the community, providing them with training and education in heart failure management to enable them to provide joint heart failure care in the future.
And they recently won an award from BHF for the innovative way in which they are working together with primary care.
Lead Heart Failure Nurse, Mandi Smith, explained that there is a high incidence of heart failure with approximately one new case per 1,000 of the population being diagnosed each year.
She said: "There are an estimated 1,540 patients with diagnosed heart failure in Highland and possibly the same again who are undiagnosed. Each year, we have around 260 people admitted to our hospitals for whom the primary diagnosis is heart failure.
"Although the prognosis can be poor, with 50% of patients dying within the first 12 months, when heart failure is appropriately diagnosed, treated and ongoing support provided, heart failure patients’ quality of life can improve.
"It also helps to keep people alive for longer and means they are less likely to require unnecessary hospital admissions."
She added that hospital readmission rates have been reduced since the service commenced in October 2006.
However, there is still a need for education and collaboration with the medical teams so that patients admitted to hospital with heart failure due to Left Ventricular Systolic Dysfunction (LVSD) are referred to the service enabling appropriate education and treatment to start as quickly as possible.
Ms Smith said: "We are building relationships with the community teams and an educational package has been produced, which allows the practitioner to work through sections of the programme using their own experience and caseload.
"We have already established effective joint working with the Nairn community team, where we currently use shared care for our patients. This not only benefits the patients, but allows the staff to have a better knowledge of the patient prior to end of life management.
"We are now planning to roll out this way of working to other areas of Highland."
Since the service began, 376 patients have been supported by the heart failure nurses and they are currently working with 188 patients. This equates to a total of 3,450 home or clinic visits, plus many more telephone contacts.
Ms Smith explained that, once a patient is stable and able to manage their condition, care is handed back to their GP practice for follow up. However, if there are any problems, either the patient or practice staff can refer the patient back into the Heart Failure Service.
The heart failure nurses also run a successful patient and carer forum in the Inverness area.
She said: “To date we have held 13 forums with between 16 and 35 people attending the sessions. We use these forums to provide education sessions using topics picked by the patients and carers. The education sessions are well received, but those attending say they particularly enjoy meeting and talking to other people who share the same disease. We would like to expand the forums to other areas, but at present we have struggled to get the representation.”
She added that they provide a newsletter after each forum, which allows them to pass on the information to others, and they are currently producing about 300 newsletters each quarter for distribution.
Patient Peter Briggs, 61, of Smithton, near Inverness, said the Heart Failure Service had made a big difference to his life.
He said: “Every time I get a visit, it makes me feel so much better. I think I’d have been quite depressed without them. Just knowing they’re there makes me feel so much happier. I really feel as though I’m getting the support I need.”