Nurses create a home care kit for heart patients
Oxygen pours from the mask of the 89-year-old man, lying in a hospital bed on the fifth floor of Martin Luther King, Jr. Community Hospital (MLKCH). It’s the 15th time Compton resident Claude Pickens been here for treatment related to congestive heart failure.
That high rate of what hospitals call “readmissions” – patients coming back again and again for the same condition – is what led a group of MLKCH nurses to pioneer a new heart-health education program that they hope will give patients the tools they need to stay healthy and out of the hospital.
Congestive heart failure patients have one of the highest rates of readmission at MLKCH. Although the reasons are many – too many fluids, spiking blood pressure – nurses noticed a common issue: Lack of education about how to manage the disease at home.
Managing heart disease requires patients to do many things – monitor their fluids, measure their blood pressure, weigh themselves regularly and understand the dangers of increased weight gain. Patients are usually given advice on how to take care of themselves when they leave a hospital. But the high numbers of patients coming back suggested this wasn’t enough.
“It was clear that talking to people once isn’t enough,” said Charlene Gozony. “Heart disease is complex. You’re not going to learn how to manage it in just one sitting.”
MLKCH nurses made a decision: they would educate their patients every day, several times a day, from the moment they entered the hospital.
They would also invest. All MLKCH heart patients now receive a package of materials to help them manage their health:
- A blood pressure cuff, to measure whether their heart is working too hard.
- A scale, which tells them if they drank too many fluids.
- A special measuring cup called a “graduate” to show them how much fluid they should drink each day.
- An informational booklet, created by MLKCH nurses, that includes a self-check plan with a “stoplight” system of care. Green means they are doing a good job of managing their health at home, yellow tells them when to pay attention to negative symptoms, and red when they need immediate medical attention.
MLKCH spends approximately $75 per patient to equip patients with these tools. But the outcome, Charlene said, is potentially priceless.
“It can make a literal life or death difference,” she said. “Patients no longer have to guess if their heart is working too hard – they have the tools to know.”
To measure patients’ knowledge, MLKCH nurses asked them to take a survey on their heart health knowledge – once at the beginning of their hospital stay and once at the end. Initial survey results show an increased understanding of how to care for themselves, Charlene reports.
“I think they’re doing a wonderful job,” said Claude, a veteran who relies upon MLKCH because it is so close to his house. “They’ve given me all the medical things I need to work with. I haven’t seen that at other hospitals.”
Heart disease particularly affects African Americans like Claude. In South Los Angeles, the mortality rate for heart disease is 44% higher than the national average.
“It’s important,” Claude said of the MLKCH program. “I think everybody should get on board with it. Your heart’s the most important thing.”