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The All India Institute of Medical Sciences (AIIMS) has started training a specialist cadre of nurses in cardiac rehabilitation programme and heart failure management. This is the first such initiative in the country, said officials.
Four nurses have been picked for the training, which started at the heart failure clinic on October 1. AIIMS plans to implement the international model of “nurse-coordinated disease management programme” in the introductory phase and they would later work independently at the heart failure clinic, the officials added.
AIIMS officials told The Indian Express the four nurses undergoing training are from the institute’s cardiology department and cardiac surgery department.
”Nurses-led heart failure clinics or what we call nurse coordinated disease management programme is being practised for years internationally. We will now create a specialist cadre at AIIMS on the same lines. They will now play a fundamental role in educating patients and the continuity of patient care. They will teach and evaluate patients’ self-care abilities such as weight monitoring, sodium and fluid restrictions, and monitoring symptoms of disease worsening,” said Dr Sandeep Seth, Professor, Department of Cardiology.
The nurses would be trained in the standard pharmacological and non-pharmacological treatment related to heart failure. They would be trained to monitor patients and educate them on the intake of drugs and the side-effects.
“In addition, the nurses will also educate the patients on aspects of self-management at home. The nurses will teach the patients different symptoms and what drugs they can increase on their own,” said Dr Seth.
The nurses will be trained at three places — at the OPD, in the hospital and also where patients undergo heart transplant.
At the OPD, officials said nurses will do immediate assessment and also educate both the patients and relatives on identifying and monitoring change in symptoms and dietary management.
Once patients get discharged, the nurses will perform the function of “discharge counsellors” and educate patients about sodium and fluid restrictions as well as recognition of signs and symptoms that indicate progression of disease. The nurses will also teach the patients about daily weight monitoring.”
“For example, an increase of 1.3 kg in body weight in two days is indicative of fluid retention. In this case, a patient should be advised to increase their diuretic dose and consult the doctor. The nurses will counsel the patients on the critical daily weight monitoring,” said Dr Seth.
AIIMS will also set up a special helpline for patients to be in touch with nurses.
“Around 30 questions or queries have been prepared. This will cover almost all aspects of heart failure. The patients can directly get in touch with the nurses during working hours. However, if the queries are not covered under the 30 questions, the nurses will refer the questions to the doctor and queries will be addressed,” Dr Seth added.
On the training of nurses when patients undergo heart transplant, Dr Seth said, “They will be present along with the ICU nurses. A checklist for heart transplant will be made and these nurses will be made familiar with the checklist. They will also be trained about heart transplant protocols and stay with the patients round-the-clock.”