Improving inpatient education and follow-up in patients with heart failure
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Author/Creator ORCID
Date
2018-05
Type of Work
Department
Nursing
Program
Doctor of Nursing Practice
Citation of Original Publication
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Abstract
Heart failure (HF) is the fastest growing cardiac disease, and it is associated with high mortality, significant disease burden, and poor quality of life and imposes a substantial cost to our healthcare system. Heart failure contributes to the highest frequency of 30-day hospital readmissions out of all causes, suggesting suboptimal self-care and inadequate inpatient and discharge management. These readmissions significantly increase risk for premature death and disability, emphasizing the need for quality improvement. The project’s purpose was to determine if 60 minutes of standardized inpatient education and scripted telephone follow-up, administered by staff nurses trained in HF, could reduce 30-day hospital readmissions. A quasi-experimental, mixed-methods design was used. Participants were recruited from two cardiac units in a mid-Atlantic medical center. Inpatients ages ≥ 18 admitted November 1, 2017 through December 31, 2017 with a diagnosis of HF were eligible. The comparison group comprised patients receiving usual inpatient and discharge care for two months prior to project implementation. Aligning with American Heart Association recommendations for Enhanced HF Discharge Education, the intervention included 60 minutes of standardized inpatient education delivered in four, 15-minute sessions and 30-day scripted telephone follow-up. A 25% reduction in 30-day readmissions was seen in the group receiving the standardized inpatient education; however, there was no difference in readmissions among patients who consented to participate in telephone follow-up versus those that declined. This project supports standardized inpatient education in minimizing 30-day readmissions, thus improving outcomes in the HF population.