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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 12/06/2026

Got a new telescope, trying some astrophotography

Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 24/03/2026

Submitted a manuscript for publication, crossing my fingers and hoping that reviewer #2 is kind to me #academic #nursing #academia #evidence-based #publication

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 02/11/2025

My co-workers call me the "prince of pee" yesterday I lived up to my nickname diuresing 15 L off a patient 😆 #medsky #nursesky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 03/09/2025

I hope residency programs in family medicine, pediatrics, PA programs, and FNP programs in Florida really bulk up the lectures for diptheria, pertussis, polio, mumps, rubella, measels, and all the other vaccine-preventable illnesses so we can at least quarantine and treat the new outbreaks to come.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 28/06/2025

Just a PSA, going off your antihypertensives in favor of a more "natural" approach is a poor way to deal with HTN, but a great way to meet a heart failure specialist. #medsky #nursesky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 19/02/2025

Reading this amazing book about nursing history & current nurse leaders. All of my #nursesky friends should grab a copy. #booksky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 13/02/2025

This medication is not intended to replace foundational GDMT, rather to be utilized in patients experiencing WHF to reduce the risk of CV death or HHF. #medsky #cardiosky #nursesky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 13/02/2025

In the VICTORIA-HF trial there was reduction in cardiovascular death and hospitalization for HF. But remember, WHF may not present solely in the hospital, clinic patients who present with volume overload requiring IV diuretics in the outpatient setting also should be considered.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 13/02/2025

For #hfweek2025 let's continue our discussion of WHF with a bit about vericiguat, a soluble guanylate cyclase stimulator. For patients who are experiencing WHF this medication has a class II indication in the current guidelines for the management of heart failure with a specific indication for WHF.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 12/02/2025

✔️ Consider addition of vericiguat based on VICTORIA-HF trial data to help reduce mortality ✔️ Referral to advanced heart failure #medsky #nursesky #cardiosky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 12/02/2025

We must treat patients with WHF with the extreme urgency that their risk demands. What can we do? ✔️ Rapid diuresis to relieve symptoms of congestion ✔️ Rapid multi-agent initiation of GDMT or optimization of existing agents

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 12/02/2025

The #hfweek2025 topic today is risk for mortality associated with worsening heart failure. As demonstrated here in this graphic, patients with WHF are at a 40-60% risk of death, far higher than ASCVD risk and much higher than in many other disease processes.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

✔️ Remember every touchpoint with a HF patient is an opportunity to evaluate their regimen and make adjustment #medsky #nursesky #cardiosky @americanheart.bsky.social @accintouch.bsky.social @hfsa.bsky.social

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

✔️ Don't be paralyzed by fear of end-organ dysfunction, remember untreated or under-treated HF leads to end-organ failure and death ✔️ GDMT is proven safe and effective in these patients with multiple trials and large patient populations

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

What can we do? ✔️ Avoid delays in therapy - consider multiple agent initiation by starting more than 1 class concurrently ✔️ Initiate therapy when patients are hospitalized - patients who leave the hospital with appropriate therapy in hand are more likely to be adherent

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

Looking at data from the EVOLUTION-HF trial displayed here the majority of HF patients after 1 year of initiation of GDMT were on sub-optimal dosing (target dosing delineated by dark green).

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

Let's talk GDMT today for #hfweek2025. Foundational therapy is ARNI, SGLT2i, BB, & MRA at OPTIMAL doses. GDMT saves lives: ‼️ Relative risk reduction 73% ‼️ Absolute risk reduction 26% ‼️ NNT = 3.9 ‼️ Extending median survival 7-11 years

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

✔️ Remember every touchpoint with a HF patient is an opportunity to evaluate their regimen and make adjustment #medsky #nursesky @accintouch.bsky.social @hfsa.bsky.social @thebhf.bsky.social @americanheart.bsky.social

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 11/02/2025

Looking at data from the EVOLUTION-HF trial displayed here the majority of HF patients after 1 year of initiation of GDMT were on sub-optimal dosing (target dosing delineated by dark green).

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 10/02/2025

We must work harder to address health disparities and to manage risk factors to prevent the development of heart failure and the progression of heart failure if it has developed. #medsky #cardiosky #nursesky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 10/02/2025

Adults <45 are rising at the top of hospitalizations for heart failure, and are outpacing older adults in mortality. The southern US alone bears nearly 50% of the entire national burden. These younger adults are presenting with more co-morbid condition contributing to mortality.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 10/02/2025

As #hfweek2025 continues, some trends in epidemiology. Currently there are ~7 million adults with HF in the US, and projected to grow to 8.5 million by 2030. Mortality is rising again after years of decline.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 09/02/2025

Today kicks off #hfweek2025 with @hfsa.bsky.social Hopefully my @accintouch.bsky.social colleagues join in spreading the word to increase visibility We as a healthcare system have so much work to do for heart failure patients, but the best thing we can all do is commit to starting GDMT early!

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 07/02/2025

Did you mean to say medial and scientific consensus?

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 31/01/2025

Despite the chaos of the world, spending an evening with a great book and this furry gremlin in my lap is the best

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 25/01/2025

I thought ortho bros only called when the ancef pump is broken

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 23/01/2025

Practicing what she preaches, if more were like her this country would be a much better place

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 16/01/2025

Seattle/King County public health has zero chill

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 16/01/2025

I will overlap in VT storm to try to quickly get to 10 gm loading and suppress dysrhythmia. But otherwise I'll do 150 followed by 1 mg/min x6 hours, 0.5 mg/min x18 hours then 400 mg BID until loading complete.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 09/01/2025

An RT I used to work with in MICU always said "you ain't gotta look good, just good enough"

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 08/01/2025

More HF rounding thoughts: you can't chart that you "optimized GDMT" if a Pt is only on an ACEi/BB. Remember GDMT is quad therapy ARNI/SGLT2i/BB/MRA at optimal doses. Every touchpoint with a HF patient is a chance to optimize therapy. #medsky #cardiologysky

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 06/01/2025

Rounding thoughts from the HF service today: 1) If no neurogenic bladder/retention and the patient is ambulatory, TAKE THE FOLEY OUT 2) With no hyponatremia, a 1500 mL fluid restriction is draconian and just makes the patient miserable 3) TED hose are your friends for LE edema

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 02/01/2025

Younger folks often have commercial insurance and can use cost savings cards, Medicaid beneficiaries often have no out of pocket costs associated with their medications. Medicare (along with Tricare) is expressly excluded from commercial savings plans.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 02/01/2025

You have the potential to be invincible. All you have to do is never enter a contest where victory isn't up to you. -Epictetus, Handbook 19a

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 31/12/2024

Well thanks to a gift from my soon to be in-laws I squeaked in 1 last NPD to end 2024. Added 1 more Pilot Custom 74 in a lovely grenadine with a fine nib. Also trying the Apica CD notebooks.

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Ben DNP AGACNP-BC AACC HF-Cert @heartnpben.bsky.social · 26/12/2024

I highly recommend this book for insight on evictions

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