Nursing Commons^™

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure results in life-altering and devastating illnesses, predominantly among older adults. Heart failure management is complex, and requires patients and their caregivers to actively monitor symptoms and sufficiently understand care management to maintain health-promoting behaviors. While home health nurses have the primary role as patient educators of their patients with heart failure, evidence from the literature indicates that nurses lack sufficient knowledge to fulfill this role.

Local Problem: Nurses’ inadequate knowledge of heart failure self-care management has been associated with insufficient patient education, the inability of patients to perform heart failure self-care management, worse clinical outcomes, and …

Exploring The Influence Of Contextual Factors And The Caregiving Process On Burden, Quality Of Life, And Outcomes Of Heart Failure (Hf) Dyads After A Hospital Discharge Guided By The Individual And Family Self-Management Theory (Ifsmt): A Mixed Method Study, Tamara Bernard

Theses & Dissertations

ABSTRACT The purpose of this study is to explore the influence of contextual factors and caregiving process characteristics on proximal outcomes of the patient and caregiver after discharge from the hospital. The long-term goal of this research is to reduce caregiver burden and improve patient outcomes. Heart failure (HF) is an increasingly common chronic illness with unique caregiving needs and a high rate of hospital readmissions. Caregiver burden has been researched extensively in other areas of medicine such as oncology and dementia and has been reported for stable chronic HF patients in an outpatient setting. However, there is little research …

Telehealth And Hospital Readmissions For Heart Failure Patients: A Literature Review, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Currently heart failure affects over six million people and is expected to increase to over eight million people by 20230. The US Census Bureau estimates over 60 million people live in a rural setting. This literature review seeks to determine the state of the science regarding the utilization of Telehealth to reduce heart failure readmissions in rural areas.

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

Revising An Order Set To Standardize The Workflow For The Outpatient Intravenous Diuretic Therapy Clinic In The Cardiac Cath Lab Holding Area, Mackenzie Trent Rasnake

Doctoral Dissertations and Projects

Heart failure (HF) is the leading cause of hospital admissions and readmissions. This produces costly hospital bills and detrimental effects on healthcare systems (Babar et al., 2020). It has been shown that intravenous (IV) diuretic therapy in the outpatient setting will reduce HF-related hospital readmissions (Abougergi et al., 2021). Outpatient IV diuretic therapy clinics are crucial for this reason. Revising an order set for the outpatient IV diuretic therapy clinic in the Cardiac Cath Lab holding area will reduce patient length of stay, improve nurse-provider communication, and increase patient and nurse satisfaction. Utilizing the Secure Chat feature within the electronic …

Education Regarding Advance Directives Improves The End-Of-Life Choices Documentation In Heart Failure Patients, Phebe Hagins Wright

Doctor of Nursing Practice Projects

Background: Heart failure affects the lives of more than 6 million people in the United States and outpatient heart failure clinics offer an opportunity to educate patients while providing evidence-based care. A needs analysis revealed that many heart failure patients do not have an advance directive (AD) on file.

Purpose: The DNP project aims to implement an educational program that provides the tools and knowledge to heart failure patients to assist patients in determining their end-of-life care goals and allow them to document these goals in the Five Wishes document.

Methods: This quality improvement project consisted of a didactic educational …

Reducing Admissions Of Adult Congestive Heart Failure Patients In The Acute Care Setting, Jamekia Calhoun

Doctor of Nursing Practice Projects

Background: Heart failure (HF) is a clinical diagnosis that affects about 1 to 2% of the population worldwide. Poor education regarding self-care behaviors after discharge has contributed to increased readmissions after acute hospitalization. Hospital readmissions cost is approximately one hundred thousand dollars. This increase in cost has forced the Centers for Medicare and Medicaid Service (CMS) to place penalties on organizations with high readmission rates. The organization may be penalized for increases in readmission rates by decreasing the percentage of the combined total Medicare payments received from the CMS (Centers for Medicare and Medicaid Services [CMS], 2021)

Purpose: …

Reducing Hospital Readmissions Through A Standardized Heart Failure Educational Program For Community Based Nurse Case Managers, Greta Abernathy

Doctor of Nursing Practice Projects

Background: Heart failure is a high-risk health condition that impacts a patient's heart, causing it to pump at a weaker pace than a healthier person's heart (Mayo Clinic, 2020). Associated with frequent hospital admissions, heart failure affects millions of Americans in the United States (Fleg, 2018) and results in repeated readmissions, costing thousands of dollars per admission and decreased quality of life.

Purpose: This DNP project aims to implement an evidence-based educational model of care for nurse case managers within a community setting focused on Heart Failure (HF) that will improve the heart failure patient's ability to self-manage their disease …

Assessing The Readiness Of Chf Patients To Use The Medisafe App To Increase Medication Adherence, Janet Lynn Kubas

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Heart failure (HF) is a complex cardiovascular disease that affects 6.2 million Americans and is associated with high morbidity and mortality, with almost 400,000 deaths annually. Medication adherence in HF can lower the risk of death and rehospitalization. As many as 46% of heart failure patients have medication nonadherence. The 2021 Update to the 2017 American College of Cardiology Expert Consensus Decision Pathway for Optimization of Heart Failure Guidelines recommends smartphones or other mobile health (mHealth) applications (apps) for medication adherence tracking. Purpose: This evidence-based practice project aimed to assess the readiness of HF patients admitted to an …

Improving Self-Efficacy In Heart Failure Care, Tracy Bennett Mcleod

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Heart Failure contributes significantly to the morbidity and mortality of the adult population and is one of the leading causes of 30-day readmissions. The cost of heart failure is a substantial healthcare burden. Purpose: The purpose of this project was to determine if implementing the “Rise Above Heart Failure” educational program would improve heart failure knowledge, weight monitoring, and reduced re-admission rates in heart failure patients. Methods: A pre-test and post-test survey named The Dutch Heart Failure Knowledge Scale was utilized. Van der Wal, Jaarsma, Moser, and Van Veldhuisen (2005) developed this questionnaire to evaluate patients' knowledge. The …

Examining How Congruence In And Satisfaction With Dyadic Care Type Appraisal Contribute To Quality Of Life In Heart Failure Care Dyads, Elliane Irani, Seunghee Margevicius

Faculty Scholarship

AIMS: Given the complexity of heart failure (HF) management, persons with HF and their informal caregivers often engage in dyadic illness management. It is unknown how congruent appraisal of dyadic HF care type is associated with dyadic health. Our aim was to examine how congruence in and satisfaction with appraisal of dyadic HF care type contribute to quality of life (QOL) for dyads. METHODS AND RESULTS: This is a secondary analysis of cross-sectional data on 275 HF care dyads (patients 45.1% female, caregivers 70.5% female). Congruent appraisal and satisfaction were assessed using the Dyadic Symptom Management Type instrument. Quality of …

Improving Discharge Outcomes: Telephone Follow Up For Heart Failure Patients, Ashley Fanjoy

Doctor of Nursing Practice Final Manuscripts

Congestive heart failure is one of the leading causes of hospitalization and readmission in the United States. The readmission rate at an acute care hospital in San Diego is 22%, and readmissions occur within an average of 6 days after discharge. The purpose of this pilot project is to improve discharge outcomes among heart failure patients using telephone follow up. The two objectives of this project are to reduce heart failure readmission rates over 3 months and improve patient knowledge to prevent decompensation, as rated by the Self Care of Heart Failure Index. Follow up calls were completed by the …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration: An Integrative Review, Purnima Krishna

DNP Qualifying Manuscripts

Purpose/Objectives: This review evaluates the published studies on how post-acute care collaboration ensures a continuum of care and reduces heart failure (HF) readmissions.

Primary Practice Setting: An integrated literature review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. PubMed and Cumulative Index to Nursing and Allied Health were searched for the keywords heart failure AND (post-acute care OR transitional care OR skilled nursing facility OR rehabilitation facility OR home health agency) AND (readmission) AND (care coordination OR collaboration OR interprofessional OR partnerships). Seventy-nine studies were returned, and a reverse reference search yielded four …

Nurse Practitioner-Led Heart Failure Education Program, Ruairi Fox

The Eleanor Mann School of Nursing Student Works

Heart failure is a chronic, progressive disease that has a global burden on the healthcare system and on patient’s lives. HF patients who experience a hospital admission are at a greater risk of being readmitted to the hospital within 30 days, impacting healthcare spending costs and patient quality of life. Self-care activities by patients, such as monitoring weight and making lifestyle changes, are the hallmark of outpatient care, and is shown throughout the literature to reduce readmissions and impact patient quality of life. Unfortunately, many patients are either unaware of proper self-care management techniques or find them hard to follow. …

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …