PURPOSE: Heart failure (HF) affects nearly five million patients in the U.S. Timely, correct assessment of potential HF, patient education and correct medication therapy is a major challenge for hospitals, but is a CMS imperative for improving survival and reducing hospital readmissions. The tele-ICU provides a unique and efficient means for early HF screening of every ICU patient. A collaborative effort with the Heart Failure Nurse Practitioners (HF NP)was evaluated as a potential means for achieving early identification of HF patients.
METHODS: The HF screening and alert process was approved by the HF Advisory Council and initiated on 02/23/2009. The goal was to fax eNurse alerts to the HF ARNP within 2 hours of ICU admission, based on: previous history of HF, admission or working diagnosis of HF, ejection fraction<40%, or admission BNP>500. The HF NP generated daily Patient Identification Reports (PIR) sent to nursing units/ICUs. The vendor sample pulled for CMS compliance reporting, covered the first few months of initiation.
RESULTS: RESULTS:Over the first 12 months a total of 1348 ICU patients were screened within 2 hrs of admission. A total of 44% of all notifications received by the HF NP were provided solely by the tele-ICU eNurses. Review of CMS compliance data for the first few months of the new service revealed 5% of all identified cases to be due to eNurse alerts alone.
CONCLUSION: Tele-ICU eNurse - HF Nurse Partnership contributed to higher rates of early HF recognition thereby increasing opportunities for timely best practice interventions.
CLINICAL IMPLICATIONS: The findings indicate added value of tele-ICU for timely HF recognition as the first step in the process of improving quality, outcomes, and CMS compliance.
DISCLOSURE: Robin Simmons, No Financial Disclosure Information; No Product/Research Disclosure Information