Heart Failure & Depression

Del Fava, Rebecca

Monday, July 11, 2011

Rebecca Del Fava, RN, BSN, MSN
South Jersey Healthcare-Elmer, Elmer, NJ
Patricia Heslop, RN, MSN, APN, CCRN
South Jersey Healthcare-Regional Medical Center, Vineland, NJ

Learning Objective 1: The learner will be able to identify possible depression in heart failure patients during the nursing assessment database.

Learning Objective 2: The learner will be able to order a consult for the APN heart failure specialist in order to complete a comprehensive depression screening.

Research has shown that heart failure patients with depression have been "re-admitted to the hospital within three months to a year after hospitalization, and are twice as likely to die than patients who are not depressed" (Rohyans & Pressler, 2009, p.3). Utilizing the patient health questionnaire (PHQ-9), our facility has adapted the PHQ-9 by incorporating two of the questions to further assist the nurses to identify possible depression in CHF patients upon admission (The McArthur Initiative on Depression and Primary Care, 2009). One study also revealed that interviews with patients has shown that one in five of those patients have depression, and the rate was found to be higher when questionnaires were used in the clinical setting to identify those at risk (Rutledge, Reis, Linke, Greenberg, & Mills, 2006).

Depressed people are less likely to be compliant with medication, diet, activity, and lifestyle changes which leads to hospitalization, re-admissions, complications, increased morbidity, and mortality. After conducting a survey of our nursing staff, the focus of the presentation is to educate nurses to identify symptoms of depression in Congestive Heart Failure (CHF) patients utilizing a depression assessment screening tool. The goal is to utilize a depression screening tool upon admission that may identify depressed patients who have been admitted with heart failure, in order to provide the appropriate intervention for the person.

References

Rohyans, L., & Pressler, S. (2009). Depressive symptoms and heart failure: Examining the sociodemographic variables.. Clinical Nurse Specialist, 23(3), 138-144. doi:10.1097/NUR.0b013e3181a443b4

Rutledge, T., Reis, V. A., Linke, S. E., Greenberg, B. H., & Mills, P. J. (2006). Depression in heart failure. Journal of the American College of Cardiology , 48(8). doi:10.1016/j.jacc.2006.06.055

The McArthur Initiative on Depression and Primary Care (2009). Patient health questionnaire. Retrieved July 4, 2010, from http://www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9/

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