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Heart failure with preserved ejection fraction (HFpEF) is a form of heart failure in which the ejection fraction – the percentage of the volume of blood ejected from the left ventricle with each heartbeat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%; [1] this may be measured by echocardiography or cardiac catheterization.
If a heart failure patient exhibits a resistance to or poor response to diuretic therapy, ultrafiltration or aquapheresis may be needed to achieve adequate control of fluid retention and congestion. The use of such mechanical methods of fluid removal can produce meaningful clinical benefits in patients with diuretic-resistant heart failure and ...
The NICHE Program provides the principles, resources and tools to stimulate a change in the culture of health care facilities and achieve patient-centered care for older adult patients. It is affordable and comprehensive, and benefits hospitals in a number of ways: Improved clinical outcomes; Positive fiscal results; Enhanced nursing competencies
Heart failure is a leading cause of hospital readmissions in the U.S. People aged 65 and older were readmitted at a rate of 24.5 per 100 admissions in 2011. In the same year, heart failure patients under Medicaid were readmitted at a rate of 30.4 per 100 admissions, and uninsured people were readmitted at a rate of 16.8 per 100 admissions.
Patient knowledge is a concern that has been observed. In 1999 Cline et al. identified several gaps in knowledge about medication in elderly patients discharged from hospital. [40] Despite receiving written and verbal information, 27% of older people discharged after heart failure were classed as non-adherent within 30 days.
Patients are less likely to request extensive acute care, nursing facility care, or in-patient services. [9] [11] Under this method, PACE serves as a cost-saving elderly care program that emphasizes on preventative, up-stream care. Notably, PACE programs saved California State $22.6 million in health care cost for elderly. [12]
Malnutrition and poor nutritional status is an area of concern, affecting 12% to 50% of hospitalized elderly patients and 23% to 50% of institutionalized elderly patients living in long-term care facilities such as assisted living communities and skilled nursing facilities. [19]
Advance directives were created in response to the increasing sophistication and prevalence of medical technology. [3] [4] Numerous studies have documented critical deficits in the medical care of the dying; it has been found to be unnecessarily prolonged, [5] painful, [6] expensive, [7] [8] and emotionally burdensome to both patients and their families.
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