Guideline Recommended Practice

Providing Self-Care Education

Patients at high risk for developing heart failure should be counseled to

  • implement those behaviors that facilitate self-care, e.g.,
    • monitor symptoms and weight fluctuations
    • take medications as prescribed
    • stay physically active
    • seek social support
    • change to a healthier lifestyle with an improved diet and exercise
  • avoid behaviors that may increase the risk of heart failure, e.g.,
    • smoking
    • excessive alcohol consumption and illicit drug use
    • use of non-steroidal anti-inflammatory drugs
    • noncompliance with medical regimen
    • high salt and/or processed food binges

Sodium Restriction

Sodium restriction is a reasonable recommendation to improve symptoms in patients with symptomatic HF. Exact restriction levels are unclear, with recommendations differing across organizations. Overall however, patients should be counseled to reduce sodium in their diets, especially from processed foods.

Performance Measure Reporting

What's Being Measured

Percentage of patients ≥18 years of age diagnosed with heart failure who were provided self-care education on three or more elements of education during one or more visits within a 12 month period.

How to Satisfy this Measure

Provide education on 3 or more self-care elements to all HF patients ≥ 18 years AND to document that the education was provided.
Self-care education elements may include, but are not limited to, the following:

  • Definition of heart failure (linking disease, symptoms, and treatment) and patient's HF cause
  • Recognition of escalating symptoms and concrete plan for response to particular symptoms
  • Indications and use of each medication (stressing that the medications work together to improve outcomes)
  • Modify risks for heart failure progression
  • Specific diet and fluid restriction recommendations
  • Individualized low-sodium diet
  • Recommendation for alcohol intake
  • Specific activity/exercise recommendations
  • Importance of treatment adherence and behavioral strategies to promote adherence
  • Importance of monitoring weight daily at home
  • Avoidance of tobacco and/or illicit drugs