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Patients with heart failure are still able to live full lives if they adhere to clinical guidelines for health; the patient’s ability to adhere to these guidelines begins with proper education. The American Heart Association has distilled these guidelines to five major points: daily weight, medication, activity, diet, and smoking cessation (American Heart Association, 2017c). Education on these five categories should be continuously taught to heart failure patientsand their families. The American Heart Association guidelines on education require that education of these five points be performed with each physician visit and each hospitalization due to exacerbation (American Heart Association, 2017a). Comparison of Standard Practice in Nevada to the United StatesThe standard practice for heart failure in Nevada is in line with national standards established by the American Heart Association. This is evidenced by using standards in education, treatment, and diagnosis. The facility I work in is accredited with both the American Heart Association and the American College of Cardiology as a chest pain center with primary percutaneous coronary intervention (Centennial Hills Hospital, 2019). While the standard practice is in line with national standards, the results of care in Nevada are lacking. The challenges for Nevada and heart failure management are related to shortages of physicians and education. Nevada is one of the fastest-growing states in the country and is also one of the largestby area (U.S. News and World Report, 2019). This growth and the sheer expanse of the state makes it challenging to have enough physicians available in areas where they are needed. The CDC reports higher-than-average deaths per 100,000 citizens in the more rural outlying areas of 8
Left-Sided Heart Failure OverviewNevada (Centers for Disease Control and Prevention, 2019b). To improve care for patients with heart failure in Nevada, improvements need to be made regarding access to care. Heart failure in Nevada is not managed well in comparison to other areas of the United States, with the primary issues being access to care and education among the patient population. Patients may wait up to six months to see a primary care physician. This delay in primary care causes an estimated 3,960 per 100,000 residents being admitted to the hospital under preventablecircumstances (U.S. News and World Report, 2019). For heart failure patients, this dearth in primary care physicians leads to many patients unable to receive treatment promptly, which in turn leads to exacerbation of symptoms and hospitalizations. Managed Disease ProcessHeart failure is a challenging diagnosis for patients: successful management requires lifestyle changes and careful monitoring. The change can be very disheartening and overwhelming for patients, so education must be clear and concise. The guidelines used in Nevada follow the education path from the American Heart Association. Patient education for