PILOT IMPLEMENTATION OF A LOW-LITERACY ZONE TOOL FOR HEART FAILURE SELF-MANAGEMENT

Background: Heart failure (HF) affects 6.5 million Americans, with one million hospitalizations, a 21.9% readmission rate, and $30 billion in healthcare costs. Self-care support tools with color-coded zones (green = stable; yellow = caution; red = take action) can help patients recognize and respond to HF symptoms and reduce readmissions and costs. Studies are lacking on zone tools' impact on HF self-care and quality of life (QoL). Purpose: The purpose of this evidence-based practice project was to test the effect of a low-literacy zone tool for HF self-management on self-care and quality of life. Methods: The author led an inter-disciplinary palliative care (PC) team in adapting an existing green-yellow-red zone tool for HF self-management. Participants were randomly assigned to a control group receiving usual care or an intervention group receiving the zone tool plus usual care. HF self-care and HF-related quality of life were measured respectively with the Self-Care of Heart Failure Index (SCHFI) and the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), at baseline and at 30 and 60 days. Results: Due to the limited sample size, the findings of this pilot project were inconclusive regarding the effect of the HF zone tool on the outcomes of interest. Implications for Practice: This EBP pilot project demonstrated the feasibility of developing and implementing a zone tool for HF self-management for patients with advanced HF in a home-based palliative care (PC) program. Further research is needed with larger samples to assess zone tools' effect on self-care and quality of life.