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Evidence Based Practice: Congestive Heart Failure

Derek Sibley
Ferris State University
















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Evidence-Based Practice: Congestive Heart Failure
This article is a study about patients with congestive heart failure, the impact it has on their lives
and the lives of their family. A part of the focus is the stress and life changes that are caused after
a diagnosis like CHF.
Conduction of Study
Article review was conducted using three databases, using several words pertaining to heart
failure, family, and caregivers. They had requirements for the articles they would select. They
must be written in English, be peer reviewed, must involve informal caregivers, etc (p. 595)
They found sixteen articles that qualified for review according to the criteria stated.
Evidence for Nursing Care
This study shows a correlation to nursing care, because as nurses, we care for the patients
and family. A disease like CHF can cause many different things to happen socially and
emotionally for the patient and the people that care about them. Knowledge about how this
disease affects different aspects of a persons life can help us to handle the situation properly and
help those people as much as possible.
limitations of study
The article states that most of the study used quantitative cross-sectional studies, and that
they could not find any randomized controlled studies for CHF patients. It also states that more
studies need to be done to assess impact of interventions for caregivers of CHF. So the authors
understand that it can contribute to evidence based practice, but isnt enough evidence for proof
of the diseases effect on patients and families. I feel like the study has validity and reliability
because the methods of the study are sound. They seem to cover all the variables. More articles

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could have been found for the literature review, but sixteen is a satisfactory amount.
Different age groups
CHF is a disease most common in aging adults, but it can strike people of all ages. When
caring for the younger generations with CHF, the family can become more distressed. Parents
usually react to a chronic disease diagnosis differently than someone older being diagnosed.
Young people are stereotyped as healthy, so a single CHF diagnosis can have a huge impact on
many people involved. CHF also causes fatigue and intolerance for activity, which can be hard to
deal with as a child that wants to fun around and play. This is not only a physical disease, but it
affects the psychological and emotional side of patients.

Relevance to nursing
This study is relevant to nursing because CHF patients are often hospitalized, and nurses
must know how to be able to communicate and provide education or therapeutic communication
when needed. According to the article, care given by family members can lead to better
outcomes (p.593). Unfortunately, caregivers of this disease have higher incidence of depression,
anxiety, and stress (p.599). This results in a need for informed and knowledgeable nurses to step
in and provide relief from responsibilities, and assist wherever possible to alleviate some of the
role strain associated with caring for a CHF patient.



Appendix A:
Patient Plan of Care
Excess fluid volume r/t
disease process
Pt. will have lung sounds
clear of excess fluid
symptoms and have no signs
of dyspnea

Monitor daily weights and
edema levels
Monitor intake and output for
excess fluid retention

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Decreased cardiac output r/t
disease process
Pt. will maintain normal
blood pressure, normal pulse,
and acceptable EKG
Administer oxygen per dr.
order
Assess pulse oximetry
regularly or continuously
Potential for decreased
endurance r/t dysfunctional
oxygen perfusion
Pt. will participate in
prescribed physical activity
with appropriate changes in
heart rate, blood pressure and
breathing rate
Minimize cardiovascular
reconditioning by placing
bedridden client upright
several times daily if possible.
Refer client to physical
therapy to help increase
activity levels and strength.



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References
Ladwig, G.B., Ackley, B.J. (2011). Guide to Nursing Diagnosis. Mosby Elsevier. ISBN: 978-0-
323-07172-7
Molloy, G.J., Johnston, D.W., Witham, M.D. (2005). Family Caregiving and Congestive Heart
Failure: Review and analysis. European Journal Of Heart Failure.
doi:10.1016/j.ejheart.2004.07.00