DNP Projects

Date of Award

7-23-2024

Document Type

Graduate Paper

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Carie Braun

Second Advisor

Carrie Hoover

Third Advisor

Nancy Romness

Subject Categories

Nursing

Abstract

In 2022, the most recent guidelines for care of the patient with heart failure (HF) were released by the American Heart Association (AHA), the American College of Cardiology (ACC), and the Heart Failure Society of America (HFSA). In summary, this group did not recommend fluid restriction for patients with heart failure, unless they are in the end stages of heart failure, and only if fluid restriction may be beneficial (Heidenreich et al., 2022). Despite this recommendation, some providers and nurses continue to restrict fluids. The aim of this DNP project, therefore, was to analyze barriers to implementation of best practices in heart failure management. In addition, the project sought to explore motivating factors that could result in practice improvement, and provide a pathway for implementing best practice in care of fluid needs of patients with heart failure. This was accomplished through in-depth interviews (n=5) across various interdisciplinary team members. Transcripts were reviewed in depth using inductive analysis (Percy et al., 2015). Three themes emerged: 1) individualizing fluid restriction; 2) organizational practice change is challenging; and 3) providers need to lead the movement toward change. Motivating factors that were identified in support of the practice change included widespread education across the organization. An important system change for this organization was to remove the fluid restriction from the inpatient order set.

Additional Files
DNP Poster.pdf (90 kB)
Project Poster
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