Unlike many disease-management interventions, a
flexible protocol guided APNs, enabling them to individualize
the schedule and content of patient care to manage heart
failure, comorbid conditions, and other health and social
problems that contribute to poor outcomes. This approach
is especially important because exacerbation of coexisting
conditions cause 40% of rehospitalizations of elders with
heart failure.6–8 In this study, patients had a mean of six
active, comorbid problems. Absolute reductions in rehospitalizations
due to heart failure (n532) and comorbid
conditions (n527) were similar. In contrast, earlier reports
of nurse-directed interventions designed specifically for
older adults resulted in substantial short-term reductions in
heart failure readmissions but no significant difference in
readmissions for other causes.
Unlike many disease-management interventions, a
flexible protocol guided APNs, enabling them to individualize
the schedule and content of patient care to manage heart
failure, comorbid conditions, and other health and social
problems that contribute to poor outcomes. This approach
is especially important because exacerbation of coexisting
conditions cause 40% of rehospitalizations of elders with
heart failure.6–8 In this study, patients had a mean of six
active, comorbid problems. Absolute reductions in rehospitalizations
due to heart failure (n532) and comorbid
conditions (n527) were similar. In contrast, earlier reports
of nurse-directed interventions designed specifically for
older adults resulted in substantial short-term reductions in
heart failure readmissions but no significant difference in
readmissions for other causes.
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