Education on Sodium Monitoring for New Heart Failure Patients

Abstract

Heart failure is a chronic illness requiring self-management to prolong individual lifespan while improving quality of life. The intent of this doctoral project was to conduct a quality improvement (QI) program focused on systematically educating patients about a two gram sodium diet, by using an educational pamphlet, provider-based patient-centered teaching, and follow up during the transition period between hospital discharge and first outpatient visit. This QI project provided systematic education for newly diagnosed heart failure patients to increase knowledge about a two gram sodium diet and facilitate translation of knowledge into self-management. The QI project used the plan, do, study, act model and was implemented by the Heart Failure Educator at Banner University Medical Center-Tucson. Patients were given the Sodium Restriction Questionnaire, to determine baseline knowledge and behavior, then educated on a two gram sodium diet and given a pamphlet with the same information for home reference. At home, patients were expected to document daily sodium intake and weight and received a phone call twice a week to obtain these values. Twice a week, patients received visual feedback to illustrate their self-management from a graph that represented personal sodium and weight values. After two weeks the same questionnaire was given to determine possible improvement. The average pre assessment questionnaire score was 19 and the average post assessment score was 21.2, showing an average improvement score of 2.2. All five patients, 100%, consumed less sodium and ingested less than two grams during the second week of monitoring sodium intake and daily weight compared to week one. Three patients, 60%, had lower average daily weight during week two by three to five pounds compared to week one. On average the patients consumed 307.18 milligrams less sodium and weighed 2.56 pounds less during week two. Results suggest that educating patients on a two gram sodium diet and providing transitional support from hospital to home, using individualized graphs and patient recording of daily sodium intake and weight, improved self-management behavior and knowledge as evidenced by improved average weight and sodium consumption and an average two point increase on the post assessment questionnaire.