Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Enhancing Heart Failure Transitional Care To Reduce 30-Day Readmission Rate, Thuy Nhu Uyen Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project is to reduce 30-day readmissions for adult patients with heart failure (HF) by implementing a standardized HF pathway beginning in the intensive care unit (ICU) and continuing through discharge.

Background: The project was implemented within a large healthcare organization in Northwest Houston, Texas.

Methodology: This project utilized a pre- and post-implementation design guided by the Plan-Do-Study-Act (PDSA) model. Eligible adult patients (≥18 years) with a primary or secondary HF diagnosis were identified during March 2026. The My Pathway to Wellness HF education pathway was initiated at the time of ICU downgrade …

Implementation Of A Cardiomems Screening Tool To Increase Provider Awareness And Referrals In Eligible Patients, Monica Rios

DNP Projects

Background: Heart failure affects over 6 million Americans and causes more than one million hospitalizations annually. CardioMEMS, a remote pulmonary artery pressure monitoring device, effectively reduces hospitalizations, yet its use remains limited due to provider and system barriers. The purpose was to increase CardioMEMS referrals for eligible heart failure patients through targeted provider education and a standardized screening tool.

Local Problem: Kentucky experiences higher heart failure hospitalization rates than the national average, contributing to prolonged hospital stays and rising healthcare costs.

Methods: A pre—post quasi-experimental study was conducted at an academic medical center. Baseline chart review of 47 patients evaluated …

Barriers To Implementation Of Practice Guidelines Against Fluid Restriction In Heart Failure, Mary Geisenhof

Nursing Posters

The overall goal was to support best practice around fluid restriction in care of the patient with heart failure.

Self-Care And Quality Of Life Of Remotely Monitored Appalachians With Heart Failure, Patrick Rexrode Murphy

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Self-Care and Quality of Life of Remotely Monitored Appalachians with Heart Failure

Patrick R. Murphy

Background: About 6.2 million persons are living with heart failure in the United States and over 960,000 new cases are diagnosed annually. The cost to provide care to this population exceeds $30 billion per year. Rates of heart failure are higher in the Appalachian region where persons are more likely to experience poverty, lack resources, and be geographically isolated. Heart failure coupled with these unique challenges can negatively impact self-care and quality of life. Numerous interventions have been attempted to support this population, but …

A Nurse Led Heart Failure Education For Self-Care Symptom Monitoring And Management, Lynda Browning

Doctoral Projects

Title

Nurse-led education heart failure education for symptom monitoring and management

Abstract

Problem Statement: Over six million adults in the United States have heart failure (CDC.gov,2020). According to the Agency for Healthcare Research and Quality (AHRQ), almost 20% of heart failure patients hospitalized are readmitted under 30 days (AHRQ, 2013). The American Heart Association (AHA) (2022) recommends a visual symptom tracking tool for self-care symptom monitoring to increase patient adherence and reduce readmissions. Despite this recommendation, the AHA tool for symptom monitoring is not fully incorporated into the discharge of every heart failure patient often because of nursing management …

Patient Experience In An Interprofessional Collaborative Practice For Underserved Patients With Heart Failure, Connie White-Williams, Maria R. Shirey, Reid Eagleson, Wei Su, Terri Poe, Brittany Fitts, Vera Bittner

Patient Experience Journal

Heart failure is a complex chronic condition that results in multiple patient visits throughout the care continuum. Patient experience has associations with clinical outcomes. The purpose of this study was to examine patient experience among the underserved in a specialized interprofessional collaborative practice heart failure clinic. This prospective study utilized both qualitative and quantitative data to describe the patient experience within an interprofessional collaborative practice. Data were collected from patient experience surveys in 1128 patients seen in the Heart Failure Transitional Care Services for Adults (HRTSA) clinic between January 1, 2018, and December 31, 2021. Interprofessional collaborative practice surveys were …

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 …

Promotion Of Heart Failure Self-Care In The Outpatient Setting, Meredith C. Lubas

Seton Hall University Dissertations and Theses (ETDs)

Medical management of chronic heart failure consists of a closely managed medication regimen, cardiovascular testing, interventions, and lifestyle modification, including self-care practices. While medication management, testing, and interventions have concrete guidelines, heart failure self-care education lacks solid guidelines and thus is often poorly defined and variable in practice. Outpatient heart failure treatment typically focuses on medication management more than self-care practices. This project addresses the current lack of heart failure self-care education in the outpatient setting.

For this project, a total of seven patients with heart failure with a reduced ejection fraction received a patient survey in order to assess …

Discovering Hidden Signs And Symptoms Of Heart Failure In The Electronic Health Record Using The Omaha System, Anita Reger

Dissertations

Purpose/Background/Significance: For the past 30 years, heart failure has been in the top 3 readmission diagnoses with patients discharged to community care. This is costly to the healthcare system and negatively impacts the patient’s quality of life. The purpose of this study is to evaluate a community care database to determine if previously under-considered latent variables exist that could provide early detection of heart failure signs and symptoms. Theoretical/Conceptual Framework: The theoretical and conceptual frameworks surrounding this work are the Omaha System and Donabedian’s structure, process, and outcomes theory for healthcare quality improvement supported by Neuman’s Systems Model. The Omaha …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing …

Standardizing The Palliative Care Referral Process, Ronaviv M. Garcia

Master's Projects and Capstones

Standardizing the Palliative Care Referral Process

Problem: Heart failure (HF) is one of the most common causes of hospital admissions and emergency department visits in the United States. HF patients are at high risk for hospital readmission: 25% of HF patients discharged from the hospital are readmitted within 30 days of discharge, and 50% are readmitted within 6 months (Vedel & Khanossov, 2015).

Context: Palliative Care (PC) has been shown to be an effective way of managing distressing HF symptoms and thus of reducing hospital readmissions, yet patients are infrequently referred to PC services during their transition from hospital to …

Assessment Of Nursing Knowledge Before And After Implementation Of Educational Intervention On Heart Failure, Sarah Scott

Dissertations

Purpose: The purpose of this study was to assess the knowledge of nursing staff on a cardiology unit before and after the implementation of heart failure specific education. Methods: Forty staff nurses on a cardiology unit at a single institution were given The Nurses Knowledge of Heart Failure Education Principles Survey (NKHFEP), a validated tool to assess nursing knowledge of heart failure. A series of four educational sessions were given to the same forty nurses. They were then given the NKHFEP survey a second time to assess change in knowledge post educational intervention. Results: The mean of Pre-education (M = …

Examining The Relationships Between Ethnicity, Palliative Care And Readmissions In The Heart Failure Population, Deanna Johnston

Dissertations

Specific Aim: The aim of this dissertation is to analyze the relationships between ethnicity, palliative care consultation and readmissions in the heart failure population at a community hospital that serves a large diverse population.

Background: Hospitals struggle with preventing readmissions. There are many interventions that can be implemented to help prevent readmissions, and Palliative Care (PC) is one of those interventions. PC has many benefits including symptom management, improved communication through the healthcare continuum, understanding of illness and treatment options, and can be provided in conjunction with curative treatments. Heart failure is one of the most common readmission diagnoses. …

The Efficacy Of The Teach-Back Method Of Education On Readmission Rates In Heart Failure Patients Within 30 Days Of Discharge, Catherine Lynch

Senior Honors Projects, 2010-2019

Background: The teach-back method is a method of education that is being used with heart failure patients in order to improve their quality of education and lower readmission rates. This literature review is aimed at synthesizing studies conducted to determine the efficacy of the teach-back method with this specific patient population.

Methods: Electronic searches of CINAHL and PubMed were performed through James Madison University libraries. Articles selected for inclusion were evaluated for study design, relevance, and sample size.

Results: Three studies met eligibility criteria, these studies showed statistically significant evidence that the teach-back method did reduce readmission rates in heart …

Evaluating Impedance Monitoring To Reduce Hospital Readmissions For Patients With Heart Failure With Reduced Ejection Fraction: An Integrative Review, Abigail Newton

Doctoral Dissertations and Scholarly Projects

Congestive Heart Failure (HF) is a chronic progressive cardiac disorder with high mortality rates and is the number one reason for hospital readmission in the United States. More than 5 million Americans live with HF with more than 900,000 new diagnoses annually. The likelihood of developing HF increases with age making it the most common primary diagnosis for patients over age 65. HF has a significant impact on quality of life, with depression being a common comorbid condition. Thoracic impedance monitoring has shown to reduce exacerbations and hospitalizations in patients with HF. This project evaluated the literature related to impedance …

Heart Failure Follow Up Phone Calls, Melissa Lampert, Anne Major

Nursing Posters

Increase the number of 72-hour post-discharge follow-up phone calls for patients hospitalized with a primary diagnosis of heart failure.

This is a quality measure required for Joint Commission Heart Failure Certification and also to maintain American Heart Association Gold Plus Status.

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

Co-Morbid Symptoms Of Depression And Anxiety And Bio-Behavioral Response To Stress In Patients With Heart Failure, Abdullah S. Alhurani

Theses and Dissertations--Nursing

Heart failure (HF) is a major public health problem throughout the world. It accounts for one death certificate among nine in the United States. Heart failure and sudden death combined are responsible for the largest number of deaths in America. The total costs of HF in the United States are estimated to be $37 billion each year. Despite substantial medical and surgical advances related to treatment of HF, it remains a very costly condition with high mortality and morbidity rates. Although biological factors contribute to high morbidity and mortality in HF, there are many unexplored psychosocial factors that also likely …

Heart Failure And Depression: Reducing Readmission Rates, Janelle Maciej

Nursing Posters

Purpose Statement: Reduce heart failure readmissions through implementation of a depression assessment in the acute care setting.