Program


Feasibility of nurse led guideline directed medical therapy clinic

May 25, 2024 from 12:40pm MDT to 1:10pm MDT

Concurrent Session: Feasibility of nurse led guideline directed medical therapy clinic

In 2021, the Canadian Cardiovascular Society (CCS) and the Canadian Heart Failure Society (CHFS) updated the pharmacological guidelines for patients with heart failure with reduced ejection fraction (HFrEF). These guidelines recommended the use of four key medications when managing patients with HFrEF. These medications include either an angiotensin-converting enzyme inhibitor, an angiotensin receptor blocker, or an angiotensin receptor-neprilysin inhibitors; a beta-blocker; a mineralocorticoid receptor antagonist; and a sodium-glucose cotransporter-2 inhibitor. When the CCS/CHFS guidelines were released, an organizational audit was completed to assess the number of patients with HFrEF discharged from hospital on guideline directed medical therapy (GDMT). This audit demonstrated a gap in the number of patients discharged on GDMT. To bridge this gap, key stakeholders discussed the feasibility of implementing a nurse led GDMT clinic. Alongside developed medical directives to guide the titration of GDMT therapy, the Registered Nurses Association of Ontario (RNAO,2012) Toolkit: Implementation of Best Practice Guidelines was used to implement this quality improvement project (QIP). The clinic includes the usual standard of care and was tailored for this patient population, as supported by the CCS/CHFS guidelines. To evaluate this QIP, an audit tool was created to monitor the various program components. The CCS/CHFS guidelines were systematically adapted and implemented using the RNAO Toolkit to tailor a GDMT nurse-led clinic for patients with HFrEF at a tertiary care institution. This QIP is the first step to determining if a nurse led GDMT Clinic has the potential to facilitate GDMT initiation and titration among those with HFrEF. 

Speakers / Panelists

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    Carolyn Doyle-Cox
    RN MSN

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    Freya Kelly
    RN, MScN

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    Lindsay MacArthur
    RN, MN