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Congestive Heart Failure Performance-Improvement Project: Special Needs for Special Patients

Bryant, Pamela K. MSN, RN


This article describes a performance-improvement project designed and implemented for Cullman Regional Medical Center’s Congestive Heart Failure Disease Management Program. A large percentage of the program’s clientele was either visually or hearing impaired, developmentally delayed, or illiterate. While the low-sodium diet-teaching sheet being utilized in the program prior to implementation of the project was excellent for some patients, it was not conducive to the disparities of the majority of the group. Many could not comprehend the diet sheet, making it difficult for them to be compliant to a diet necessary for disease control. The project consisted of a new, low-sodium diet-teaching sheet designed by the author and implemented over a 6-week time period. The tool was subsequently evaluated by administering a patient satisfaction survey. Outcomes and processes of the project are analyzed. Systematic evaluation of costs, data collection processes, benchmarks, and the utilization of technology are examined, as well as health and cultural beliefs of the clientele. The lessons learned as a result of implementing a simple modification to an existing teaching tool are shared.

Pamela K. Bryant received her ADN degree in 1978 from Wallace State Community College in Hanceville, Ala., her BSN degree in 1982 from the University of Alabama in Birmingham, and her MSN degree from the University of Alabama in Tuscaloosa in 2001. She was inducted into Sigma Theta Tau International Honor Society of Nursing in 1982. Her clinical experience of 24 years includes critical care, endoscopy services, home health, physician office, and cardiovascular nursing. This article was written during graduate studies and edited for publication in May 2002.

Address correspondence and reprint requests to Pamela K. Bryant, MSN, RN, 1400 E. Hanceville Road SE, Cullman, AL 35055 (e-mail:

© 2002 Lippincott Williams & Wilkins, Inc.