Core Measures for Heart Failure

[rebbylynne]

Hi there,

I am a nursing student, and I will be presenting a powerpoint on Heart Failure to my clinical class. I am having difficulty finding a list of the core measures for this disease process. If you happen to know where I could find this list, I would so appreciate it if you could give me the link! I have checked out the Joint Commission's website multiple times, and but to no avail.

Thank you so much for your time!

[traumaRUs, MSN, APRN]

Moved to nursing student assistance

[pmabraham, BSN, RN]

If you are referring to lab values, BNP is what we were taught.

[203bravo, MSN, APRN]

The joint commission removed heart failure from core measures reporting requirement in 2014.. probably the reason that you are having some difficulty finding current material. Here are the original measures that were in effect 2001 - 2014: best of luck.

Core measure: ACEI or ARB

ACEIs reduce the risk of HF-associated deaths by 15% to 25%. (An ARB may be substituted in patients with ACEI allergies). ACEIs include captopril (Capoten), lisinopril (Prinivil or Zestril), enalapril (Vasotec), and ramipril (Altace). ARBs include losartan (Cozaar), valsartan (Diovan), and irbesartan (Avapro). These drugs continue to decrease both mortality and the number of re-admissions among HF patients.

Core measures: LVF assessment

Evaluation of LVF guides treatment for HF patients and must be documented in the patient's medical record. Ideally, the best time to evaluate LVF is during the patient's initial evaluation. However, many patients with longstanding HF have never had LV assessment. Currently, proof of LV assessment must be documented on every hospital admission.

Two-dimensional echocardiography with Doppler is used to assess left ventricular ejection fraction (EF), left ventricular size, wall thickness, and valve function. EF indicates HF severity, guides treatment, and correlates mortality and morbidity risks. Normal EF values range from 50% to 70%.

Core measure: Smoking-cessation counseling

HF patients who have quit smoking report improved quality of life. Clinicians should recognize the value of smoking cessation for all patients, but especially for HF patients because it decreases their comorbidity risks.

Core measure: Discharge instructions

Discharge instructions for HF patients should include diet, daily weight measurement, medication use, signs and symptoms that their condition is worsening, and follow-up plans. In conjunction with electronic medical records, medication reconciliation on admission and discharge has streamlined medication changes. In outpatient settings, physicians provide slightly different patient education, including the definition of HF and risk-factor modification. Patient and family teaching must be adapted to their level of understanding.

[rebbylynne]

Thank you so much everybody!

[rebbylynne]

Thank you so, so much! You have really helped me!