Ann Frantz

Breaking down the barriers to heart failure patient self-care.

Optimal care of patients with heart failure is often related to the patients’ inability to transition to independent care. This article discusses the barriers to heart failure self-care and how effective patient education focused on a multilevel approach can increase adherence to self-care routines and decrease hospital readmission.

Lessons learned from telehealth pioneers.

Just as American pioneers imagined a future in the West, telehealth visionaries envisioned a new way of delivering healthcare. Four home care telehealth innovators share their experiences including the support and barriers associated with this new technology. Each of the users interviewed in this article were pioneers in using the LifeSigns telehealth monitor, which consists of a monitor that measures a patient’s blood pressure, pulse, ECG, and oxygen saturation in the home. Each user adopted the technology in various ways that would meet their specific needs, making their experiences both similar and unique. Their responses will assist home care organizations, clinicians, and clinical managers in recognizing how telehealth can be efficiently implemented in their settings. Survey participants were Baptist Home Care (BHC), New Brunswick Heart Center in Canada (NBHC), University of Tennessee Medical Center (UTMC), and Cardiovascular Home Care (CHC), Fort Worth, TX.

Matching telehealth applications to the patient, clinician, and agency's needs.

Telehealth offers many opportunities to provide evidence-based, cost-effective home care practice. To ensure success administrators, managers, and clinicians must identify their agency’s telehealth goals and compare these with technology manufacturers’ recommendations. This article provides a list of considerations agencies can use to evaluate telehealth programs objectively. Successful telehealth applications are also presented.

Cardiac home care programs impact patients after coronary artery bypass grafting.

Many hospitals have initiated early discharge programs in an effort to transition coronary artery bypass grafting patients home as quickly as possible. To meet the needs of patients who are discharged early, several home care agencies have created special cardiac programs. This article describes the common components of six successful home care cardiac programs.

Exploring expert cardiac home care nurse competence and competencies.

Consistent with cardiac national practice guidelines, many home care agencies employ expert cardiac nurses to practice in cardiac home care programs. Agencies have needed a tool for evaluating who is an expert at the time of hire, as well as delineating ongoing required competencies for expert cardiac nurses. This article presents a competence statement, sample competence evaluation questions, and competencies associated with expert cardiac nursing practice.

About the cardiac home care nursing practice guidelines.

Currently the guidelines recommend measurement of the PR and QRS intervals on single lead ECG rhythm strips. These ECG landmark measurements help determine whether the electrical pathway during the beat is within normal limits. The QT interval helps determine whether ventricular depolarization and repolarization have occurred within a normal time frame (usually 0.08 seconds or less). Prolonged QT intervals can indicate that patients may have: