Our Nurses Take Patients’ Needs to Heart
Oxygen pours from the mask of the 89-year-old man lying in a hospital bed on the fifth floor of the Martin Luther King, Jr. Community Hospital (MLKCH). It’s the 15th time Compton resident Claude Pickens has been here for treatment related to congestive heart failure.
It’s this kind of high rate of readmissions—patients coming back again and again for the same condition—that led a group of MLKCH nurses to pioneer a new heart health education program that they hope will give patients the tools they need to stay healthy and out of the hospital.
“They’re doing a wonderful job. They’ve given me all the medical things I need to work with. I haven’t seen that at other hospitals.” —Claude Pickens, Compton resident and MLKCH heart patient
Congestive heart failure patients have one of the highest rates of readmission at our hospital. Although the reasons for this are many—including too many fluids and spiking blood pressure—nurses noticed one very common issue: lack of education about how to manage the disease at home.
Managing heart disease requires patients to do many things: monitor their fluids, measure their blood pressure, weigh themselves regularly, and understand the dangers of increased weight gain. Patients are usually given advice on how to take care of themselves when they leave the hospital. But the high numbers of patients coming back suggested this wasn’t enough.
“It was clear that talking to people once wasn’t enough,” said Nursing Manager Charlene Gozony. “Heart disease is complex. You’re not going to learn how to manage it in just one sitting.”
MLKCH nurses made a decision: they would educate their patients every day, several times a day, from the moment they entered the hospital.
They would also invest in the tools. All MLKCH heart patients now receive a package of materials to help them manage their health:
- A blood pressure cuff, to measure whether their heart is working too hard
- A scale, which tells them if they have consumed too many fluids
- A special measuring cup, called a “graduate,” to show them how much fluid they should drink each day
- An informational booklet, created by MLKCH nurses, that includes a self-check plan with a “stoplight” system of care (green means they are doing a good job of managing their health at home, yellow tells them to pay attention to negative symptoms, and red indicates when they need immediate medical attention)
MLKCH spends approximately $75 per patient to equip patients with these tools. But the outcome, Charlene said, is potentially priceless.
"Using the tools provided can impact their lives in positive ways and prevent early death," she said. "Patients now leave with the tools necessary to maintain their disease at home and prevent early readmissions."
To measure patients’ knowledge, MLKCH nurses ask them to take a survey on their heart health knowledge—once at the beginning of their hospital stay and once at the end. Initial survey results now show a far higher level of understanding about how to care for themselves, Charlene reports.
“I think they’re doing a wonderful job,” said Claude, a veteran who relies upon MLKCH because it is so close to his house. “They’ve given me all the medical things I need to work with. I haven’t seen that at other hospitals.”
Heart disease particularly affects African Americans like Claude. In South Los Angeles, the mortality rate for heart disease is 44% higher than the national average.
“It’s important,” Claude said of the MLKCH program. “I think everybody should get on board with it. Your heart’s the most important thing.”