Heart failure in the long-term care setting. [American Medical Directors Association]

info@guidelines.gov (NGC), 2010

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To improve the quality of care delivered to patients with heart failure in long-term care facilities
To guide the recognition, assessment, and management of patients with heart failure who reside in long-term care facilities
Initial workup (if determined appropriate) for reversible etiologies of heart failure (chest x-ray, coronary angiography, detailed cardiopulmonary history, electrocardiogram, laboratory tests [complete blood count, serum electrolytes, thyroid function, renal function, liver function, and lipid profile], physical examination, serum levels of brain natriuretic peptide [BNP] and N-terminal-proBNP [NT-proBNP])
Determination of whether interventions are appropriate for reversible etiologies of heart failure
Management of reduced left ventricular ejection fraction (LVEF): angiotensin-converting enzyme (ACE) inhibitors, aldosterone antagonists, beta-blockers, digoxin, diuretics, isosorbide dinitrate/hydralazine
Management of heart failure with preserved LVEF: ACE inhibitors, beta-blockers, calcium-channel blockers, diuretics, nitrates
Monitoring of patient's condition and response to treatment (signs and symptoms, weight, vital signs, functional performance, electrolytes, renal function, magnesium, drug levels where indicated)
Medline, PubMed, and geriatric-specific journals such as the Journal of the American Medical Directors Association (JAMDA), Annals of Long Term Care, and Journal of the American Geriatrics Society (JAGS) were searched from May 2009 through February 2011.