California Baptist University, USA
Scientific Tracks Abstracts: J Clin Exp Cardiolog
In 2016, I established a heart failure program in a large primary care clinic. The fundamental goals of this clinic were to decrease hospital readmissions and improve patient outcomes. In the United States, three trillion dollars a year is spent on health care. Additional, 50% of the total expenditures are concentrated among just 5% of the population. This highly concentrated spending is centered on patients >65 years of age with at least one chronic disease, heart disease being the most common. Heart failure readmissions are a significant burden on the nation├ó┬?┬?s healthcare system. The 30 day readmission rate for the diagnosis of heart failure across the nation is 25%, climbing to 50% at the six-month mark. The astonishing factor is that 75% of these readmissions have been deemed preventable. So, the question remains, why can├ó┬?┬?t we as health care professionals prevent them? I began the heart failure program in hopes of closing the gap from hospital to home, however, in the midst of gathering data something amazing happened. I began to see the patients, not from the provider├ó┬?┬?s side, but the patients. I began to ask the right questions and found that many of the patients that were unsuccessful had one common theme. They scored low on their self-efficacy questionnaire that was given on their first visit to the heart failure clinic. Self-efficacy is the belief in one's capability to succeed. Various studies have shown that despite the severity of a patient├ó┬?┬?s disease, those with high self-efficacy showed improved quality of life and fewer hospitalizations. I believe if we can improve our patient├ó┬?┬?s self-efficacy through education and empowerment we can improve our patients quality of life and by doing so decrease the overwhelming burden of frequent hospitalization on the healthcare system.
Christy Cotner has received her RN license 18 years ago and completed her MSN FNP at California State University Dominguez Hills, and is nationally certified through AANP. She is currently completing her DNP in the study of heart failure and self- efficacy. She is the Director of the family nurse practitioner program at California Baptist University where she has advanced education through the work of standardized patient simulation. Additionally, she works in internal medicine at Riverside Medical Clinic with a specialty in heart failure. She has Spear-Headed the development of various programs throughout her career which include an emergency room case management program, gastric bypass program, acute care cardiac nurse practitioner program, and the medical home model. She is an active Member of NONPF involved in a program director sig group. She is also an active Member of CANP and looks forward to advancing the profession of the nurse practitioner.