Keep ticking: congestive heart failure self management program

Abstract

The social determinants of health are factors that impact an individual’s ability to self-manage congestive heart failure. Social determinants of health impact adherence to treatment and self-monitoring. Assessing how the social determinants of health impact patients on an individual level improves patient-centered care planning and health education. Registered nurses play a key role in facilitating access to health care resources and promoting healthy behaviors by building effective relationships and fostering open communication. There is a gap in practice within the Calgary Integrated Home Care Program in what patients need to be supported with, and what they end up being supported with. The Keep Ticking: Congestive Heart Failure Self- Management program offers an education seminar to registered nurses working with heart failure patients that highlights how the social determinants of health affect heart failure management, the role nurses have in addressing heart failure management, and provides strategies in which nurses can use to improve the delivery of health education. This program also uses an assessment tool that nurses use with heart failure patients to identify specific self-management barriers related to the social determinants of health and acts as a guideline in how nurses can help support patients in mitigating those barriers. This program has shown to be effective in improving health education by assessing baseline understanding of patient’s knowledge in heart failure management. Further assessment tool adaption and timing is required to improve its applicability in the home care program. Future program implementation will focus on collaboration and building relationships for effective patient-provider relationships. Nurses in the home care setting are limited on how they can address barriers related to the social determinants of health. Action is required beyond the level of care that home care nurses can provide, and further intervention is required on a social and political level.