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Managing Congestive Heart Failure in Porirua Presenter: Martin Hefford Hospital: C&CDHB

Managing Congestive Heart Failure in Porirua Presenter: Martin Hefford Hospital: C&CDHB. 15-16 June - Broadbeach. KEY PROBLEMS. Marked ethnic disparities in congestive heart failure morbidity & mortality

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Managing Congestive Heart Failure in Porirua Presenter: Martin Hefford Hospital: C&CDHB

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  1. Managing Congestive Heart Failure in PoriruaPresenter: Martin HeffordHospital: C&CDHB 15-16 June - Broadbeach

  2. KEY PROBLEMS • Marked ethnic disparities in congestive heart failure morbidity & mortality • A 1987-98 found that Maori mortality from heart failure at ages 45-64 years was over 8 times the rate of nonMaori • Deaths for cardiovascular disease in Porirua are 20% higher than the district average

  3. INNOVATIONS IMPLEMENTED • Mobile specialist CHF nurse & administrative support added to an existing cardiology service. • Intensive follow up and support for people with CHF • improved secondary/primary care liaison, • training sessions for primary care staff,

  4. INNOVATIONS IMPLEMENTED • Exercise programmes and other support for people living with heart failure and their families • Goup education & support programmes • Family education & support to address risk factors. • Pilot programme

  5. OUTCOMES SO FAR: HOSPITAL INPATIENT EVENTS & ALOS

  6. OUTCOMES SO FAR: NARRATIVE • Mr A had 10 admissions to the medical ward at Kenepuru with numerous problems in 2003. He is in his 50’s and lives with his wife, daughter (who is very overweight) and her 8 year old son. After first meeting Mr A, Janet spent some time in the initial stages building a rapport with him and his family while he was in hospital. He stated he felt frightened and that he was not being listened to by health professionals. • He and his whole family are now exercising regularly and are all involved in a weekly walk at Aotea Lagoon. Janet says that when meeting with this family, it is not about creating a teaching moment, but recognising a learning opportunity. His admissions to hospital have now stopped and he appears more confident. His problems are multifactorial and while heart has been the reason for some of his admissions, ownership, empowerment and support for him and his family have been the driving force in the decrease of his admission rate.

  7. HOW WE DID IT • Project Started: October 2003 • Staffing: 1 nurse specialist • Funding: < $100,000 • Duration: 18 Months

  8. LESSONS LEARNT • Issues re sole position • Isolation • Cover for leave • Important elements: • Immediate response • Small caseload • Working with the family • What we would do differently • Locate within primary care.

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