PIPOST method was adopted to establish evidence-based questions: according to the evidence pyramid principle and search strategy, 2 evidence-based nursing backbones completed literature search in both Chinese and English, and finally included 7 literatures (see Table 1), including 4 guidelines and 3 expert consensus (see Table 2 and Table 3), Summarize on the top 20 pieces of evidence (see Table 4). Focusing on the three key links of capacity assessment, monitoring and management, stakeholders were invited to evaluate each piece of evidence according to the FAME principle, that is, the feasibility, suitability, effectiveness

Note: (1) Is the source of the opinion clearly marked? (2) Does the opinion come from an influential expert in the field? (3) Is the proposed view to study the relevant person Group interest-centered? (4) Is the conclusion as stated based on the results of the analysis? Is the expression of ideas logical? (5) Do you refer to the other existing literature? (6) Is there any inconsistency between the proposed views and the previous literature?

and clinical significance of evidence (see Table 5). Finally, 11 best pieces of evidence were obtained (see Table 6) and 5 clinical review indicators of cost projects were transformed (see Table 7).

Indicator 1: The survey on nurses’ knowledge of capacity management was carried out based on the questionnaire on knowledge, trust and practice developed

based on Delphi method, with 51 items in 3 dimensions and 18 nurses; Indicator 2: Patients (or caregivers) were informed of capacity management related education; Indicator 3: Body mass monitoring was carried out and the results were

recorded, standardized procedures were determined, and capacity management plans were implemented. 152 patients were observed on site, department files and mobile medical workstations were consulted and checked; Indicator 4: departments have standardized multidisciplinary team diagnosis and treatment system process and implementation; Indicator 5: Departments have standardized heart failure follow-up system and procedures, 28 medical staff to review department documents. Identify obstacles and construct action strategies (see Table 8).

There were significant differences in LVEF and self-care ability of patients before and after treatment (p < 0.05). In terms of volume management indicators, the dry-body mass compliance rate was increased from 40.1% to 64.4%, while the read hospital admission rate and BNP value had no significant difference (p > 0.05) (see Tables 9-11).

1) The scores of doctors’ and nurses’ attitude towards volume management increased from 10 to 18, knowledge from 32 to 55, and behavior from 9 to 16 (all p < 0.05) (see Table 12).

2) Re-examination of the review indicators after the application of evidence: 174 patients admitted from June to October 2021 were used as the trial group for the second round of baseline review, and the results showed that all 5 indicators were improved (see Figure 1).

Formulation and practice of volume management plan for patients with chronic heart failure.

1) As a unit of the heart failure Center alliance, promote the capacity management program to the radiated medical institutions, and update the concept through training.

2) To carry out special training for hospitals in the Alliance area, organize provincial and municipal continuing education training courses, expert consultation, free clinic screening activities, help cooperative hospitals to establish heart failure centers, send medical backbone grass-roots services, and expand the use of syndrome nursing.

Cardiac ultrasound examination can judge the functions of the heart, LVEF value is the reflection of cardiac systolic function, LVEF normal value in 50% - 70%, the increase of LVEF value indicates that the heart failure symptoms are improved [8] . After the application of evidence, the difference of LVEF was lower than before the application of evidence, this study made patients realize the importance of volume management by correcting previous management errors through face-to-face demonstration, one-to-one guidance, providing management tools to better master the volume management method, more accurately assess their own fluid retention, reduce the risk of volume overload, and have a certain positive impact on their heart contraction function [9] . BNP is important for the diagnosis of heart failure, differentiation of cardiac function, and prognosis, and is positively correlated with the severity of heart failure [10] . The results of this study showed that the difference in BNP between the two groups before and after the evidence application was not significant, which contradicted the study results of Ni Jian [11] and Chen Hua [12] . The analysis reason may be that the intervention time in this study was one month, which should be extended to 3 months to further observe the changes of plasma BNP concentration in CHF patients.

Hospital-discharge readmission rates in elderly patients with chronic HF remained high, with up to 20% within 1 month. The readmission rate within 3 months after discharge can be as high as 30%, and the risk of all-cause death is significantly increased by 4 to 6 times [13] compared with patients not hospitalized with heart failure. During rehospitalization, the cardiac function will show progressive decline, and the congestion symptoms will be more serious. The results of the study readmission rate showed a significant difference between the two groups in March after discharge (p < 0.05), consistent with the results of Lin Li [14] and Jiang Y [15] et al., patients with this model could establish and maintain volume management behavior, thus exerting the significant effect of volume management in reducing the readmission rate of patients with heart failure.

The main reason for frequent hospitalization in patients with heart failure is volume overload, and dry body mass refers to the body mass of patients with heart failure without the symptoms and signs of congestion. In this study, the body mass on the day of discharge was used as the reference standard of dry body mass [16] . In the control group of this study, most of the patients were obviously volume overload, and those who failed to meet the standard after discharge before evidence application.

Patients with chronic heart failure generally have fatigue, fatigue dyspnea and edema and other physical symptoms, some patients. It will also be accompanied by psychological symptoms such as anxiety, depression and other psychological symptoms, which significantly reduce the quality of life of patients [17] , and low quality of life is associated with the number of readmissions of patients with chronic HF, which will significantly increase the risk of death, which can be used to predict the prognosis of patients [18] . The higher the MLHFQ score represents the worse quality of life, the score after the evidence application was lower than before the evidence application and the difference was significant, and the representative pattern has a significant effect on the improvement of short-term quality of life of patients in the intervention group.

The evidence-based capacity management scheme for CHF patients can significantly improve the self-care ability of patients and their caregivers, reduce the risk of capacity overload, improve the quality of life of patients, and promote the post-hospital rehabilitation effect of CHF patients.

Improve the cognition, teamwork spirit, evidence-based ability and scientific research quality of medical staff on capacity management of CHF patients.

1) Focus on clinical hot spots and difficult problems, and apply the latest and best evidence to chronic heart failure volume management; 2) The outcome indicators involved in improving the volume management behavior and health outcomes focus on the current national cardiovascular quality control index 1 and nursing quality control index 2; 3) The concept radiates from the hospital to the outside, and is promoted to 13 medical institutions in northwest Hubei, forming a certain influence at the city and county level.

1) Passed the certification of “Heart Failure Center” in 2021, actively promoted the linkage up and down, graded diagnosis and treatment, and established the CHF capacity management network medical link system. The capacity management has covered 13 prefecty-level network medical link systems such as Songzi, Jianli, public security, Shishou, a number of community service stations and township health centers around the region; 2) Since June 2021, a total of more than 879 health records for patients with heart failure have been established to conduct standardized capacity management of them, and improve patients’ cognition and self-care ability through four aspects: body quality monitoring, drug intervention, health education and follow-up; Among them, 237 patients were revisited; Two-way referral of 35 patients; And remote consultations 26; 3) Carried out 8 “Heart failure network regional cooperative hospital training meetings”; Held 2 provincial and municipal continuing education training courses “New Progress in Heart failure Diagnosis and Treatment Study Class 06-2022-03-01-008” and municipal continuing education project “New Progress in Cardiovascular Disease basic Hospital Promotion Study Class 2022-03-01-024”; On-site expert consultation, free screening activities 6; 4) Selected key doctors and nurses to conduct center construction and capacity management program guidance training for cooperative hospitals, and 2 cooperative units have passed the certification unit of grassroots heart failure center.