- Are symptoms stable?
- Are they still symptomatic? If so escalate treatment as per pathways
- Are they becoming fluid overloaded or dehydrated?
- Record weight, blood pressure and pulse
- Check and record pulse rhythm using a code
For Heart Failure with a reduced ejection fraction:
For Heart Failure with preserved ejection fraction:
- Renal function, potassium, sodium, haemoglobin stable?
|Comorbidities and risk factors
- Hypertension, Diabetes, Atrial fibrillation
- Smoking cessation
- Alcohol intake
- Cognitive status and nutritional status
|Other tests and treatments
- Flu / pneumococcal vaccine is recommended for all HF patients
- Annual ECG: if QRS width is newly >130ms (3.25 small squares) then refer for reassessment in hospital HF clinic (to consider Cardiac Resynchronisation Therapy)
- Consider resuscitation status and advanced care planning
As per NICE guidance we aim that patients should be discharged back to GP care once all appropriate hospital therapies have been considered.
Heart failure treatment pathways
The community heart failure nurses also have limited
capacity and do not routinely review stable patients once they have been
established on a suitable medication regime.