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Program Profile:
Cardiac Disease Management
The Cardiac Disease Management program was created in 2005 with the training of three cardiac nurses with prior ICU and ER experience, using courses in cardiovascular assessment and EKG (electrocardiogram) interpretation. The result is the program’s current strategy of evaluation and treatment in accordance with physician orders, utilizing a multi-disciplinary plan of care designed for an optimal outcome.
Emphasizing the importance of this program’s focus, Carol L. Weber, VNSW’s President and CEO, notes that acutely ill, hospitalized patients are often discharged on multiple medications, a potential but not immediately apparent source of problems that the program can help overcome.
“These patients really need comprehensive cardiovascular assessments,” explains Carol. “We watch their response to the medications, because there can be arrhythmias as a result of the medications. There can be a dramatic change in their cardiac output, which we need to monitor on a continuing basis.”
Reasons for such monitoring are multiple. “Some people go into arrhythmias that have not been diagnosed, as the patient is unaware, and they should be on anti-coagulation therapy. Since arrhythmias can lead to stroke or heart attack, these are vital to identify and treat.”
After doing some research, the Team found that this approach to rhythm assessment is “absolutely unique” to VNSW’s Cardiac Disease Management Program. “ We’ve spoken to a lot of reps of other programs,” says Carol, “and they tend not to do rhythm assessment, probably for lack of the proper equipment. We found an EKG that weighs 4 oz. and fits right into our laptop computers, a software/hardware combination. We can do an EKG and a rhythm strip on the laptop at the bedside at home.”
“This is very important. Three quarters of the patients who have congestive heart failure die from arrhythmias. The very first day we used this new monitor, it revealed that a patient was having frequent dysrhythmias. The doctor was called and was faxed a copy of the rhythm strip by the VNSW nurse. A 24-hour Holter Monitor was performed, which showed that this patient was having longruns of a very serious dysrhythmia. The patientwas treated promptly and a very serious consequence was avoided. I believe we saved her life.”
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