Nurse-Directed
Outpatient Clinics
Clinic management for the patient with CHF can
be provided by various health personnel and can
include many aspects of care (Table
2).
Nurse-
directed clinics have shown significant results in
implementing and managing secondary preven-
tion in patients with coronary heart
disea~e~~
as
well as with heart failure management. Cline et
aI’6
conducted a prospective, randomized trial on
190
patients who were discharged with a primary
diagnosis of heart failure. Baseline characteristics
for control and intervention groups included
mean age of 75 years; mean NYHA class 2.6; mul-
tiple diagnoses, including previous
myocardial
in-
farction, HTN, and
atria1
fibrillation; and 70% use
of diuretics. ACE