CCCN Abstracts S403

myocardium, usually leading to heart failure. Although thereare different causes and classifications of cardiomyopathy,many symptoms and treatments are similar. Females requiringhospital admission are typically beyond child bearing years.The purpose of this presentation is to describe a case study ofa young female, with a previous diagnosis of idiopathiccardiomyopathy, admitted to a tertiary care cardiology inpa-tient unit while in her second trimester of pregnancy. Thepatient was cared for on the cardiology inpatient unit until thebirth of the baby. This unique clinical encounter required thecoordination and collaboration from several disciplinesincluding cardiology and obstetrics. The case study willhighlight the management and treatment plan, review theconsiderations in the management of complications such asheart failure and arrhythmias and describe some of the chal-lenges cardiac nurses faced in caring for an individual witha unique clinical situation over an extended period of time.This case study illustrates the considerations in the manage-ment and treatment of patients with a diagnosis of cardio-myopathy with complications while pregnant. It is hoped thatthe knowledge gained from our local experience will behelpful to cardiac nurses to successfully care for similarpatients elsewhere.

N034PUMP UP YOUR KNOWLEDGE: HOW TO CARE FOR PATIENTSWITH VENTRICULAR ASSIST DEVICES (VADS) IN CARDIACREHAB

W Chiu, A Kaan, J Kealy, E Laquer, D Cuff

St. Paul's Hospital, Vancouver, BC

Patients who undergo VAD implantation in British Columbia(BC), generally live at home while waiting for a heart trans-plant. Seventy five percent of patients come from outside ofthe implanting health authority.Following implantation, VAD recipients are often de-condi-tioned from symptoms of advanced heart failure prior tosurgery. In 2013, the International Society for Heart andLung Transplantation Guidelines for Mechanical CirculatorySupport: recommended that “all patients who are able shouldbe enrolled in cardiac rehabilitation (CR) after surgicalplacement of a mechanical circulatory support device”.With a growing population of patients living outside of thelocal area, we encountered resistance when referring patientsto local CR due largely to lack of knowledge about VADs andtheir management, especially during exercise. To that end, wedevised an education training program for community CRstaff to become familiar and comfortable with accepting andcaring for VAD patients. The training program involves a goaloriented learning plan along with buddy shifts at our hospi-tal's cardiac rehab program and access to a 24/7 emergencyhotline for advice and support.This paper will describe the challenges encountered during thedevelopment of this program, present the details of theprogram and provide information about feedback andproposed modifications.

Empowering outlying hospitals’ CR programs with VADeducation and hands-on experience will allow these patients toattend CR closer to home with the aim of improving atten-dance, quality of life and long-term outcomes.

N035DEVELOPMENT OF AN ELECTRONIC SIGN-OUT TOOL TOIMPROVE COMMUNICATION AND PATIENT SAFETY DURINGHANDOFFS IN CARE

M Rodger

Toronto General, Toronto, ON

Throughout their hospitalization, patients will be cared forby many different health care providers. This createsopportunities for error when clinical information is notaccurately transferred between providers during handoffs incare. The primary objective of sign-out is the accuratetransfer of information about a patient's state and plan ofcare from one set of health care providers to another (Pat-terson et al., 2004). Sign-out processes vary from hospital tohospital and unit to unit. In order to create a structured andeffective exchange of information during sign-out, thecardiovascular surgical team at University Health Networkimplemented an electronic sign-out tool. In this presenta-tion, the components of the electronic sign-out tool and thestructured handoff and sign-out protocols will be summa-rized. Lessons learned regarding design and implementationof an electronic sign-out tool will be discussed. Emphasiswill be placed on how the sign-out tool improved work flowof nursing and medical staff and continuity of care for ourpatients.

N036SELF-CARE IN HEART FAILURE INDEX- DO SCORES CHANGEOVER TIME?

K Harkness1,2, G Heckman2,3, L Jewett2, R McKelvie1,2

1Hamilton Health Sciences, Hamilton, ON, 2McMaster University, Hamilton,ON, 3University of Waterloo, Waterloo, ON

The self-care in heart failure index (SCHFI) is a validatedinstrument comprised of three subscales measuring self-caremaintenance, self-care management and self-care confidencein patients with heart failure (HF). Based on studiescomparing scores between patient groups, SCHFI authorsstate that a subscale change score of 8 points is clinicallysignificant; however, longitudinal studies measuring SCHFIscores within individuals are lacking. The purpose of thislongitudinal, descriptive pilot study was to determine if thereis a change in scores for each of the SCHFI subscales in HFpatients who completed the SCHFI at entry to a HF clinicand again in 6 months. From the 23 participants whocompleted baseline testing, 17 participants completed followup testing. Participants’ (n¼17) mean age was 72 SD 9years and 71% had NYHA class III symptoms at baseline.The SCHFI self-care management mean scores at baselineand 6-months were 45.6 (SD 21) and 63.2 (SD 23)