Evidence-Based Practice for Acute Decompensated Heart Failure

Nurses must dismiss myths associated with managing patients with acute decompensation with evidence-based strategies. The authors provide management goals and actions associated with the most common clinical manifestation, fluid retention.

Each year, chronic left ventricular systolic and diastolic dysfunction, or heart failure, causes 1 million hospitalizations in the United States.¹ Heart failure is the most common Medicare diagnosis related group at discharge^1,2 and is associated with poor survival and quality of life. In addition, cost of care is high; in 1998, Medicare paid out $3.6 billion for care related to heart failure.¹ 

The Acute Decompensated Heart Failure National Registry (ADHERE)³ recently reported data on 14716 patients hospitalized for heart failure in the United States (Tables 1 and 2). Generally, patients admitted to the hospital for heart failure were elderly, were female, had a history of heart failure, and were unable to carry out activities...