Challenges in Heart Failure Disease Management in Skilled Nursing Facilities: A Qualitative Study.

Morrow, Cynthia D.; Perraillon, Marcelo C.; Wald, Heidi L.; Nelson, Jennifer L.; Reeder, Blaine P.; Battaglia, Catherine; Boxer, Rebecca S.

Clinical guidelines recommend clinicians in skilled nursing facilities (SNFs) monitor body weight and signs and symptoms related to heart failure (HF) and encourage a sodium restricted diet to improve HF outcomes; however, SNFs face considerable challenges in HF disease management (HF-DM). In the current study, we characterized the challenges of HF-DM with data from semi-structured, in-depth interviews with patients, caregivers, staff, and physicians from nine SNFs. Patients receiving skilled nursing care were interviewed together as a dyad with their caregiver. A datadriven, qualitative descriptive approach was used to understand the process and challenges of HF-DM. Coded text was categorized into descriptive themes. Interviews with five dyads (n = 10 individuals), SNF nurses and certified nursing assistants (n = 13), and physicians (n = 2) revealed that, among the sample, HF care was not prioritized above other competing health concerns. Staff operated in the challenging SNF environment largely without protocols or educational materials to prompt HF-DM.

COLORADO; HEART failure treatment; CAREGIVER attitudes; THERAPEUTICS; ATTITUDES of medical personnel; RESEARCH methodology; ATTITUDE (Psychology); PHYSICIANS' attitudes; INTERVIEWING; NURSING care facilities; PATIENTS' attitudes; QUALITATIVE research; DESCRIPTIVE statistics; RESEARCH funding; THEMATIC analysis; DISEASE management

Journal of Gerontological Nursing, 2022, Vol 48, Issue 5, p13

0098-9134

Academic Journal

10.3928/00989134-20220404-04