The role of the specialist nurse.

Heart failure is growing in incidence as a result of the aging of the population and of improved survival from myocardial infarction. However, quality of life is poor among patients with heart failure, and has shown to be worse than in most chronic conditions. These patients often have a poor prognosis—around 50% of those with severe heart failure will die within the first year. Since this is a condition associated with high admission rates, high readmission rates, and lengthy hospital stays, heart failure is associated with a high financial burden; the annual direct cost of heart failure to the National Health Service (NHS) in 1990-91 represented over 1% of the total NHS budget. Against this background, there is increasing evidence to show the important role that specialist heart failure nurses can play in the management of patients with heart failure.