Atelenursing system in the management of heart failure

During the emergency period of the Covid 19 pandemic, the suspension of outpatient activities determined by public health measures and the focus of the health system on emergency management, highlighted the need to implement systems for providing nursing services remotely. In particular, managing patients with chronic cardiovascular disease requires having the ability to verify adherence to the therapy, to provide health education to patients and their caregivers, and to continually monitor clinical conditions in order to maintain a health reference and the constancy of a therapeutic relationship. Objectives: Evaluate the usability and effectiveness of a telehealth system for providing supportive and protective nursing care for patients with chronic heart failure and their caregivers. Case Report: From 10 October to 11 November 2020 we enrolled 15 clinically stable patients followed by our Heart Failure Clinic: 13 M,2 F (avg age 63.2 yr, range 49-74 yr). Protocol Patients were provided with a system of devices measuring and transmitting the following vital parameters: temperature, O2 saturation, HR, ECG. It was agreed with the patients that the data would be transmitted twice a week and/or according to clinical needs. Video calls were made weekly for the first month and biweekly for the next two months, using the IT platform. The presence of signs and symptoms of clinical instability, adherence to the plan of treatment and the need for health education and psychological support were monitored through standardized interviews, and by observing patients during video calls. At the end of the course, a questionnaire was administered to investigate the degree of satisfaction of the therapeutic intervention. Results: Continuous monitoring of health status, strengthening of the patients' adherence to the therapy, support for caregivers, ability to recognize early signs of instability of the heart disease. Video calls provide the ability to analyze non-verbal language as well as the patient's daily life context, allowing to be more effective and empathetic compared to telephone contact. Nursing educational intervention reaches patients and caregivers at their home, finding them more receptive and with a smaller anxiogenic component than in the hospital setting. Results from the final questionnaire reveal full satisfaction with the nursing intervention, which gives value to the service offered, although there are some limitations that can be improved in the future.