Скачать презентацию The STOP HF Screening Programme Elaine Tallon RGN Скачать презентацию The STOP HF Screening Programme Elaine Tallon RGN

d7be23ad02559dbd4f00064a0d68d8c5.ppt

  • Количество слайдов: 34

The STOP HF Screening Programme Elaine Tallon RGN, RM, PG Dip Clinical Specialist Nurse The STOP HF Screening Programme Elaine Tallon RGN, RM, PG Dip Clinical Specialist Nurse

The dreaded blood testing and cholesterol The STOP HF Screening Programme The dreaded blood testing and cholesterol The STOP HF Screening Programme

The terrifying weighing scales The STOP HF Screening Programme The terrifying weighing scales The STOP HF Screening Programme

The ever so lovable blood pressure!!!!! The STOP HF Screening Programme The ever so lovable blood pressure!!!!! The STOP HF Screening Programme

Discuss • Look back at where The STOP HF programme has evolved from • Discuss • Look back at where The STOP HF programme has evolved from • Where we are today • Tips for keeping healthy The STOP HF Screening Programme

Definitions: • BNP: B-type natriuretic peptide- which is a protein that is released from Definitions: • BNP: B-type natriuretic peptide- which is a protein that is released from the heart muscle when it is under stress or strain. • ECHO: Echocardiogram – scan of the heart. • ECG: Electrocardiogram – looks at the electrical activity of the heart. • Heart Failure: Where the muscle of the heart does not work as well as it should The STOP HF Screening Programme

Where we started: • The STOP HF research programme started in 2004 • Main Where we started: • The STOP HF research programme started in 2004 • Main aim of seeing if the BNP blood test could be used to identify early signs of stress or strain on the heart muscle. The STOP HF Screening Programme

 • • 2005 began recruiting From GPs surgeries-Dublin, Wicklow, Wexford >40 yrs of • • 2005 began recruiting From GPs surgeries-Dublin, Wicklow, Wexford >40 yrs of age Risk factors-hypertension, cholesterol, diabetes, prior heart attack Randomisation-control and treatment arm Reviewed yearly in GPs surgery If BNP > 50 pg/ml treatment arm – had echocardiogram & seen by Prof Mc. Donald to assess and ensure all risks under tight control Education re healthy lifestyle The STOP HF Screening Programme

 • In 2011 – all participants were reviewed in SMH and had ECG • In 2011 – all participants were reviewed in SMH and had ECG and ECHO done • In 2012 – reviewed all participants data including events / admissions to hospital The STOP HF Screening Programme

Outcome of analysis / research: Showed that the BNP is a good subtle indicator Outcome of analysis / research: Showed that the BNP is a good subtle indicator together with • Collaborative care between hospital and GP • Managing your risk factors tightly • Good lifestyle choices resulted in less strain on the heart muscle, less incidents of heart failure and other serious cardiovascular events. The STOP HF Screening Programme

Hence, we could not continue as a research programme but we are now a Hence, we could not continue as a research programme but we are now a SCREENING programme where everyone gets the same care / follow up. • Only reason we are consenting - so that we can use your blood for medical research including genetic testing and that it can be sent to facilities outside Ireland for testing. The STOP HF Screening Programme

Assessment has not been changed: • Take history of risk factors, up to date Assessment has not been changed: • Take history of risk factors, up to date medical & surgical history, medications prescribed, any symptoms • Check your weight, height, BMI, abdominal girth, blood pressure, heart rate • Blood sampling for BNP, Cholesterol, Glucose and medical research • ECG and ECHO The STOP HF Screening Programme

Frequency of assessment Dependent on BNP result: – BNP <20 pg/ml – every 3 Frequency of assessment Dependent on BNP result: – BNP <20 pg/ml – every 3 years – BNP 20 – 50 pg/ml – every 2 years – BNP >50 pg/ml – every year IMPORTANT: • Do NOT worry about BNP result • Subtle indicator & guide to your treatment • What really matters is how you are feeling and results of other tests The STOP HF Screening Programme

After your assessment • Nurse & doctor review your visit and all test results After your assessment • Nurse & doctor review your visit and all test results • If we have any concerns we will ask you to come in and be seen by doctor / have further investigations if necessary • Automatically whether you are seen by a doctor or not a letter with all investigation results will be sent to your GP The STOP HF Screening Programme

How you can prevent stress / strain on the heart muscle Good blood pressure How you can prevent stress / strain on the heart muscle Good blood pressure control • Aim for <140/85 mm. Hg The STOP HF Screening Programme

Good cholesterol control More happy: >1. 0 mmols/L -Exercise -Oily fish -Porridge Less lousy: Good cholesterol control More happy: >1. 0 mmols/L -Exercise -Oily fish -Porridge Less lousy: <3. 0 mmols/L <2. 5 mmols/L – diabetes <1. 8 mmols/L-known heart disease The STOP HF Screening Programme -Low saturate fats -Grill or bake food -Lean meat

Good diabetic control The STOP HF Screening Programme Good diabetic control The STOP HF Screening Programme

Weight • Keep your weight down - BMI < 24. 9 • Through what Weight • Keep your weight down - BMI < 24. 9 • Through what you eat, drink and exercise • Weigh yourself weekly • Aim to lose a pound a week The STOP HF Screening Programme

Present weight statistics of those attending STOP HF: • BMI < 24. 9 (normal Present weight statistics of those attending STOP HF: • BMI < 24. 9 (normal weight) = 25. 1% – Male = 18. 2% Female = 31. 1% • BMI 25 – 29. 9 (overweight) = 40. 9% – Male = 43. 7% Female = 38. 5% • BMI >30 (obese) = 34% – Male = 38. 1% Female = 30. 4% The STOP HF Screening Programme

Exercise • Half hour brisk walk/cycle/swim 5 -6 times per week to keep healthy Exercise • Half hour brisk walk/cycle/swim 5 -6 times per week to keep healthy and well • Up to an hour 5 -6 times per week if you need to lose weight The STOP HF Screening Programme

Exercise If problems with joints / back walk in the pool The STOP HF Exercise If problems with joints / back walk in the pool The STOP HF Screening Programme

DIET • Aim for a well balanced healthy diet plan that you can maintain DIET • Aim for a well balanced healthy diet plan that you can maintain for life • Avoid fad diets • Little and often of the right foods The STOP HF Screening Programme

DIET Suggest if you need to lose weight • Breakfast- oat based cereals –porridge DIET Suggest if you need to lose weight • Breakfast- oat based cereals –porridge or unsweetened muesli with low fat milk or yogurt • Mid morning – piece of fruit • Lunch – 2 slices brown bread with your proteinoily fish or lean meat or low fat cheese or egg • Mid afternoon – piece of fruit • Dinner – 2 medium sized potatoes or ¼ plate wholemeal pasta or brown rice, ½ plate of vegetables, fish, chicken or lean red meat • Avoid eating after 6. 30 pm The STOP HF Screening Programme

DIET • Aim for 5 portions fruit / vegetables per day • Watch sugary DIET • Aim for 5 portions fruit / vegetables per day • Watch sugary foods – cakes, chocolates, biscuits, sweets – have as treat only 1 -2 times/week • Watch the sugary drinks • Avoid salt – use pepper, herbs, spices • Watch the sauces, salad dressings • Avoid processed foods, ready made meals, take aways - best make your own The STOP HF Screening Programme

Diet Remember: Watch what you bring into the house – if it’s not there Diet Remember: Watch what you bring into the house – if it’s not there you can’t have it! The STOP HF Screening Programme

ALCOHOL Women = 11 units/week max Men = 17 units/week max (HSE guidelines – ALCOHOL Women = 11 units/week max Men = 17 units/week max (HSE guidelines – low risk drinking) One standard unit = The STOP HF Screening Programme

NO Smoking • Never too late to stop • Not easy to stop but NO Smoking • Never too late to stop • Not easy to stop but well worthwhile for a good quality of life • Smoking Cessation courses St. Vincent’s University Hospital The STOP HF Screening Programme

Reduce STRESS levels ---> The STOP HF Screening Programme Reduce STRESS levels ---> The STOP HF Screening Programme

Reduce STRESS levels • • • Accept there are events you can’t control Good Reduce STRESS levels • • • Accept there are events you can’t control Good work / life balance If carer, make sure to take time for yourself Do pleasurable things -Walking, reading, gardening Try to keep positive Get enough sleep Eat well Avoid alcohol and smoking Seek social support Get help if you feel you are not coping The STOP HF Screening Programme

Take your medications as prescribed • They are usually for life • Don’t stop Take your medications as prescribed • They are usually for life • Don’t stop them unless doctor tells you to • Know your medications • Keep list of names, doses and how often you take them in your wallet / purse • Try not to miss doses • Be honest with your doctor if you are not taking your medications The STOP HF Screening Programme

Have regular medical check ups The STOP HF Screening Programme Have regular medical check ups The STOP HF Screening Programme

Conclusion • STOP HF SCREENING programme • Frequency of visit as per your BNP Conclusion • STOP HF SCREENING programme • Frequency of visit as per your BNP results • Your doctor will be informed of all your test results The STOP HF Screening Programme

Attempt to keep your risk factors under control through healthy lifestyle choices that you Attempt to keep your risk factors under control through healthy lifestyle choices that you can maintain for life The STOP HF Screening Programme

Thank you all And I hope to The STOP HF Screening Programme Thank you all And I hope to The STOP HF Screening Programme