Heart Failure Prevention Daniel Ruiz
Grand Canyon University: NRS-429V
March 16, 2014

Heart Failure Prevention There has begun a shift from acute care in the hospital setting to a more preventative approach, taking place in the community. With this shift, nurses will be taking a more involved role in preventing disease and promoting health. As healthcare evolves and changes over time, so has the role of the nurse. They will be seeing an increase in their responsibilities in implementing health promotion and disease prevention that can be approached in three different levels, primary, secondary and tertiary health promotion prevention. Health promotion is the process of helping people improve their lifestyle and taking steps towards more optimal health. The purpose of health promotion in nursing practice is just that, to help those they care for increase their health and quality of life. The nurse implements this improvement in several different areas. The nurse collaborates with those around them, other nurses, physicians, social workers and other interdisciplinary staff. The nurse advocates for individuals to ensure they are receiving the care they deserve and to help the individual learn to advocate for themself. The nurse is a case manager, collecting information and passing it along. They are a consultant and educator, teaching and providing information to help promote the health of the individual, family and community. The nurse provides direct services and follows the provider’s orders. Healer, the nurse helps those under their care balance the different parts of their lives. The nurse is a researcher, learning and finding evidence-based practice to help promote health and prevent disease (Edelman & Mandle, 2010). When looking at health promotion and the prevention of disease, one can look at heart disease being an epidemic in this country. An estimated 5.5 million people in the United States have heart failure, causing 12-15 million office visits and 6.5 million hospital days per year. This costs the American people $30 billion (Butler, 2012). And heart failure is only on the rise, so it is important for nurses to understand their roles and responsibilities in promoting health and helping reduce heart failure. This author has reviewed three different articles that look at the three different preventative approaches of heart failure. Primary prevention with heart failure is helping people learn how to change their lifestyle before a cardiac event occurs. This is an important opportunity for the medical community to save lives, improve quality of life and to save healthcare costs. There are risk factors that nurses need to be aware of assessed for when looking at patients. Risks include age, gender, hypertension, obesity, diabetes, sedentary lifestyle, poor diet, high alcohol and sodium consumption, smoking and several other comorbidities. The most common method used to diagnose heart failure is the Framingham criteria that looks at the patient being at risk when having two major and two minor of the set criteria. When a nurse is aware that a patient is at risk for heart failure they can implement their designated methods of promoting health by teaching a healthier lifestyle. This includes teaching how to maintain a healthy wait, smoking cessation, changes in diet with low sodium intake, increase of whole grain, fruits and vegetables, importance of regular physical activity, maintaining hypertension and diabetes and moderate alcohol intake. Assessing for the risk of heart failure can be difficult due to the number if differing opinions and diagnostic uncertainty, this is one contributing factor why most approaches to heart failure focus on secondary prevention as opposed to primary prevention (Butler, 2012). Studies have shown that lifestyle changes and medications can reduce the chances of death and injury related to heart failure, but there is a deficit in the teaching provided by the healthcare community and the ability for patients to follow directions that were given. Secondary prevention of heart failure occurs after a cardiac event occurs, for example an acute myocardial infarction, but before serious damage has occurred. The nursing approaches and education follow all of the same ones as primary prevention teaching. This second article reported that even after patients received education on lifestyle changes, the majority still reported poor follow through with that education. Patients who were more likely to be successful had a strong support system, had a sense of fear (not wanting to have another cardiac event), and better self-control. For nurses to help their patients maintain success they need to be part of the support system, teaching and encouraging their patients and following through to ensure that the patients were able to retain the given information (Doyle, Fitzsimmons, McKeown & McAloon, 2010). Tertiary prevention happens in regards to heart failure after permanent damage has occurred and the patient needs prevention in relation to reducing the effects of the disease and receiving treatment to increase their quality of life. The third article reviews the effects of a cardiac tertiary prevention program after patients receive coronary artery bypass graft (CABG) surgery. CABG surgery is the frequently used procedure to treat coronary artery disease. These programs look to help reduce injury and death by also helping their patients work towards a healthier lifestyle. All of the approaches used in the primary and secondary prevention levels are also used to help promote better health in these patients. This study discussed the difficulty of educating these patients has increased due to the decreased amount of stay in the hospital. This makes it even more important for the nurse and healthcare staff to provide meaningful education and to follow through with that education. It also shows the increasing importance of the nurse in the community and their need to continue with the education and support since patients are spending less time in the acute care setting (Mosayebi et al., 2011). When looking at all three levels of prevention with regards to heart failure, it was important for patients to be educated in a healthy diet, regular exercise and smoking cessation to help promote the health and well-being of these patients. This author sees that this education and approach promoting health is not only beneficial with heart failure, but with the prevention and treatment of any disease. This author also learned more amount the need and the importance of the nurse in the community setting. The community nurse’s responsibilities are only on the rise due to several factors related to shorter hospital stays, the increase number of people requiring healthcare and the cost of healthcare. They will be an important key to the success and promotion of the health of those under their care.

References
Butler, J. (2012). Primary prevention of heart failure. ISRN Cardiology, 1-15. doi:10.5402/2012/982417
Doyle, B., Fitzsimons, D., McKeown, P., & McAloon, T. (2012). Understanding dietary decision-making in patients attending a secondary prevention clinic following myocardial infarction. Journal Of Clinical Nursing, 21(1/2), 32-41. doi:10.1111/j.1365-2702.2010.03636.x
Edelman, C., & Mandle, C.L., (2010). Health promotion throughout the lifespan (7th ed.). St. Louis: Mosby.
Mosayebi, A., Javanmard, S., Mirmohamadsadeghi, M., Rajabi, R., Mostafavi, S., & Mansourian, M. (2011). The effects of cardiac tertiary prevention program after coronary artery bypass graft surgery on health and quality of life. International Journal Of Preventive Medicine, 2(4), 269-274.