Feasibility Study of a Nurse-Led Heart Failure Standardized Education Program to Reduce 30-Day Readmission

Monday, 30 October 2017: 9:50 AM

Martha Sissay Awoke, DNP, MSN, RN
Department Case Management, Medstar Georgetown University Hospital, Washington, DC, DC, USA
Diana Lyn Baptiste, DNP, MSN, RN
Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD, USA

Purpose/Objectives: Heart failure is a burdensome condition that affects more than 6 million Americans and an estimated 23 million people worldwide. Individuals living with heart failure often experience shortness of breath, edema, and fatigue leading to frequent hospital admission. Heart failure is the most common cause of hospital readmission. Studies show that nearly 24% of heart failure patients are readmitted within 30 days and 30% of heart failure patients are readmitted into an acute hospital within 60-90 days. Frequent readmission is a financial burden on patient families and the health care system. The cost of treating heart failure, including lost wages and lost productivity is estimated at $32 billion a year. Evidence suggests a nurse-led heart failure inpatient hospital education improves knowledge and self-care behavior and potentially reduce 30-day readmission. Knowledge addresses patients’ understanding of the association between disease progression, symptoms, and treatment plan.

 In this study, we implemented a nurse-led heart failure education to improve patients’ knowledge about the heart failure disease process. The purpose of this quality improvement program was to standardize a nurse-led heart failure patient education and evaluate its impact on knowledge, and all cause 30-day hospital readmission at a large urban academic medical center.  

Methods: We implemented an evidence-based standardized heart failure patient education program with telephone follow-up. A convenience sample of (N=27) individuals diagnosed with heart failure were asked to complete the Dutch Heart Failure Knowledge Scale at baseline and 7 days post-discharge.

Results: Descriptive statistics were analyzed using SPSS® version 24 to provide demographic characteristics for the sample. The mean age for the sample (N=27) was 66.3, ranging from 54-90 years, almost evenly distributed gender, and most of the sample size reported they were either unemployed, retired, or disabled. Of the total participants, 61% had an ejection fraction less than 55% and 39% had a New York Heart Association IV classification. The mean baseline knowledge scores for (N=12) participants who completed the Dutch Heart Failure Knowledge Scale increased from 12.3 to 13.25 (p= .005) at 7 days post-discharge.  The all-cause readmission rate after the intervention was 17.2%, a reduction from 22% previously reported prior to the intervention.

Conclusion: Implications from this study suggest the importance of implementing standardized education programs that are focused on improving knowledge for heart failure patients. Findings suggest that implementation of a nurse-led standardized heart failure education program that is focused on improving knowledge may reduce 30-day readmission for individuals with heart failure. Nurses are uniquely qualified to implement standardized evidence-based patient education to promote positive health outcomes in local and global settings.