Managerial Decision Making Bachelor Essay Example | Topics and Well Written Essays - 3000 words

Managerial Decision Making Bachelor - Essay Example The focus will be on the need for heart failure specialist nurses in the community and how they can improve health care in the UK. The 80-year-old female patient I have chosen to discuss here appears to fit the overall criteria for the above study, which was mainly focused on previously hospitalized patients with interventions through specialist heart failure services in the community. My client was diagnosed with heart failure two years ago and had one additional admission to hospital about one year ago for exacerbation of her heart failure. She felt she had not been given adequate information on her condition. She was referred to community heart failure nurses for education, management and titration of Carvedilol 6.25mg bd. Other heart failure medication prescribed included furosemide 80mg mane, spironolactone 25mg mane and ramipril 5mg bd. The spironolactone was stopped due to increased potassium, urea and creatnine, a decision based on the RALES study (2003). After another admission for chest infection, she was discharged without furosemide, and I was assigned as a community heart failure nurse. She was con cerned about having her furosemide discontinued, and it was recommenced after I contacted the physician. The client feels more secure knowing she has someone to contact rather than "bothering" her doctor, and we have developed a good rapport. I am working with her on pharmacology issues, making sure she is responding well to her medications as well as taking the right medications. Heart Failure - Major Health Problem Heart failure has continued to be an escalating public health problem. Chronic heart failure is the "syndrome of breathlessness, fatigue and fluid retention resulting in impaired ability of the heart to pump properly" (Sanderson, 1994, par. 1), often following a heart attack. By the end of the 1990s, 5% of all medical admissions to hospital in UK were related to chronic, or congestive, heart failure (Bosson, 1997). The Department of Health considers it a major concern because there is no cure at present. It therefore has a dramatic effect on the quality of life, and if not properly managed in the community it can also place very heavy pressures on hospital beds through emergency admissions and re-admissions (DOH, 2003). Local GPs in a 2005 clinical audit who had access to a specialist CHF nurse considered the service far more important than did the GPs without a specialist nurse. Even with the existence of guidelines, the treatment for heart failure in UK continues to be suboptimal, a concern which makes the specialist CHF nurse increasingly valuable (Leslie, 2005). The 80-year-old female client whose care I am monitoring no doubt will find herself increasingly dependent on others, and if she doesn't have proper treatment her quality of life will be greatly diminished. The purpose of this paper is to determine whether this type of care in the community not only will lessen the need for hospital inpatient care but ultimately will