A heart failure nurse specialist is a nurse who specializes in the field of heart failure. Heart failure nurses provide counseling to patients, families, and healthcare providers. They are the point of contact for the entire care process for heart failure patients and are involved in all patient services. Heart failure nurses sometimes participate partially in daily nursing care and represent an important link between physicians and other healthcare providers (both inside and outside the hospital). They contribute to quality and research projects and participate in the organization of care and follow-up and in the education of patients and healthcare providers.

The most important tasks of the heart failure nurse are:

1) Patient and family/caregiver education to promote patient autonomy, self-monitoring, self-care, and well-being ( empowerment ). The heart failure nurse strives to improve :

• Disease insight:
  • Inform about diagnosis (what is heart failure?), treatment and prognosis.
  • Check that the information is correctly understood.
  • Teach the patient the importance of self-monitoring of parameters (weight, blood pressure, heart rate, renal function, etc.)
  • Educate the patient about warning symptoms, including those of impending cardiac decompensation, and what to do if these symptoms occur.
  • Teach the patient about necessary lifestyle adjustments.
• Therapeutic insight:
  • Explanation about the treatment (drugs and implantable devices) and their potential side effects.
  • Teach the patient the importance of good compliance with treatment and lifestyle measures.
  • Explanation of target weight and correct dynamic diuretic use with dose adjustment according to weight evolution and clinical symptoms of fluid retention.
  • If necessary, the heart failure nurse can contact the home pharmacist.

2) Psychosocial support and assessment of the family situation, the patient's autonomy and the social framework. In the event of a problem, additional help will be requested from social services, dietician, physiotherapist, geriatric support team (GST), psychologists, intercultural mediators, pastoral staff, tobacco specialist.

3) Follow-up of patients with heart failure, both in hospitalized patients (intramural) and outpatients (transmural and extramural):

• Intramural :

• • Heart failure patients admitted to the cardiology department.
    Read: Hospitalization for heart failure.
    • Education about heart failure, the treatment and life style adjustments.
    • Explanation of the parameters to monitor and the use of the heart failure diary.
    • Planning of follow-up at discharge.
    • Communication with primary care providers.
    • Telemonitoring after discharge.

• • Patients with heart failure admitted to non-cardiology departments.
    Read: Hospitalization of a patient with heart failure in a non-cardiology department.
    Follow-up of heart failure related parameters :
    • Clinical status: parameters (blood pressure, heart rate and weight) and possible signs of fluid retention.
    • Blood tests (renal function, ionogram, etc.).
    • Infusion policy (avoid or limit IV saline, NaCl infusions).
    • Checking the continuation of the heart failure medications and advices for adjustments if needed.
    • Checking for eventual administration of to be avoided drugs (e.g. NSAIDs, NaCl infusions).
    • Planning of follow-up at discharge.
    • Telemonitoring after discharge.

• Extramural :

• • Hospital consultations.
    • Heart failure consultations with the cardiologist.
    • Possibly, dedicated consultations by the heart failure nurse for clinical monitoring, adjustment of medication doses/titration (under the supervision of the cardiologist), etc.
  • Telephone contacts (to the patient and/or their companions, as well as to first-line care providers) in the event of unexpected cardiac problems.
  • Telephone monitoring of patients (monitoring after discharge from hospital, for example).
  • Telemonitoring of patients with heart failure: specific monitoring of heart failure, monitoring of possible heart rhythm disorders and implanted devices (in collaboration with the rhythm clinic).
  • Sharing and transmission of specific training in heart failure for general cardiology nurses, home and nursing home nurses.
  • Data management: continuous updating of heart failure specific databases.