Date of Award

Spring 5-12-2023

Document Type

DNP Project

Project Team Faculty Member

Danielle Loftus


Heart Failure, Heart Failure with Reduced Ejection Fraction, Nursing Education, Quality Improvement


Clinical Issue
Heart failure claims one in four lives of those diagnosed each year. The term Guideline Directed Medication Therapy (GDMT) represents optimal medication therapy as defined by the American College of Cardiology Foundation and American Heart Association. Appropriate quadruple therapy results in an estimated 73% relative reduction in mortality over a two-year time span (Greene & Khan, 2021). However, there is a gap in proper GDMT stemming from suboptimal initiation and/or titration in the outpatient setting.

Project Implementation
Nursing staff in a rural midwestern cardiology clinic were provided with an in-service presentation discussing current guidelines and recommendations of GDMT through visual, auditory and kinesthetic adaptations.

A pre- and post-educational survey was given to the nurses. The pre-test questionnaire had an average score of78.3%. The post-educational questionnaire showed an average of 90.6%. Nursing staff then ranked their confidence and understanding on a scale of one to five. These scores reflected that the nursing staff felt more confident in their knowledge of GDMT medications and their mechanism of action along with their knowledge of the statistical benefit GDMT offers this patient population.

Clinical Implications
Project results revealed increased knowledge of GDMT therapy by 18%. The immediate impact on practice is an increase in knowledge for the nurses, which will promote the evaluation of GDMT through staff. Long term impact of this quality improvement project would be an anticipated reduction in mortality, cardiovascular risk, overall hospitalizations, and hospitalization for heart failure as proper treatment is implemented.

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