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This paper outlines a proposed quality improvement initiative aimed at enhancing compliance with daily weight monitoring for heart failure (HF) patients on a cardiac step-down unit. The critical nature of daily weights in HF management and the consequences of poor compliance, as identified through a hypothetical Root Cause Analysis (RCA), are discussed. Several IT projects designed to promote compliance are identified, including automated weight documentation, smart scale integration with real-time alerts, and a nurse education module on data-driven HF management. The paper emphasizes the crucial importance of health data literacy for nurse leaders in driving such initiatives and fostering a data-informed culture. Finally, it details the essential interdisciplinary team members, their roles, and their contributions to the successful implementation of these IT projects.

Keywords: Heart failure, daily weights, quality improvement, nursing informatics, health data literacy, IT projects, team development, nurse manager.

Introduction

As the newly appointed nurse manager of a bustling Heart Failure/Cardiac step-down unit, my primary objective is to cultivate an environment of excellence in patient care and operational efficiency. Heart failure is a chronic, progressive condition that requires meticulous management to prevent exacerbations, reduce readmissions, and improve patient quality of life. A cornerstone of effective heart failure management is the accurate and consistent monitoring of daily weights, which serves as a crucial indicator of fluid status and the effectiveness of diuretic therapy. Despite its recognized importance, compliance with daily weight protocols can often be challenging due to various systemic and human factors.

This paper will delineate a quality improvement project aimed at significantly enhancing compliance with daily weight monitoring for heart failure patients on our unit. Through a hypothetical Root Cause Analysis (RCA), we have identified that suboptimal health data literacy among nursing staff contributes significantly to inconsistencies in this vital practice. Consequently, this initiative will propose several IT-driven solutions designed to streamline the process, improve data accuracy, and empower nurses with better access to actionable information. Furthermore, this paper will underscore the paramount importance of health data literacy for nurse leaders in championing such projects and fostering a data-driven culture. Finally, it will detail the essential interdisciplinary team members required to successfully plan, implement, and sustain these IT projects, outlining their specific roles and contributions.

Nature and Significance of the Local Problem: Daily Weight Compliance in HF Patients

Heart failure is a leading cause of hospitalization and readmission in adults over 65, posing a significant burden on patients, healthcare systems, and national economies (Centers for Disease Control and Prevention [CDC], 2023). Effective management hinges on a multi-faceted approach, with daily weight monitoring being a fundamental, non-invasive method for assessing fluid balance. Rapid weight gain (typically 2-3 pounds in 24 hours or 5 pounds in a week) often signals fluid retention and impending decompensation, allowing for timely intervention with diuretics or other adjustments to the treatment plan (Yancy et al., 2017). Conversely, significant weight loss can indicate excessive diuresis, leading to dehydration and electrolyte imbalances.