Role of Advanced Practice Nurses in Decreasing Length of Stay and Rehospitalization for Heart Failure Patients

Wednesday, 24 July 2013: 10:30 AM

Sisay Mersha, MS, ACNP
Cardiology, Presence Health, Saint Francis Hospital-Evanston, IL, Evanston, IL

Learning Objective 1: Explore APNs' role in decreasing length of stay and readmission

Learning Objective 2: Participants will leanr how APNs are uniquely positioned to intercept length of stay and readmission rate,and contribute in the health system of the nation

Purpose: The purpose of this project was to review existing literatures on the role of APNs in reducing length of stays and rehospitalization after discharge. The project also aimed to evaluate heart failure programs across one of the largest Catholic healthcare systems in a large Midwestern city.

Methods: A comprehensive literature search was conducted using keywords from MEDLINE, CINHAL, EMBASE and PubMed data bases. Relevant studies published in English from1990 to 2011were retrieved. The studies were appraised and systematically analysed for common themes regarding APN’s roles in reducing the unnecessary LOS and readmissions.

Results: Of 651 studies retrieved, 14 articles met the inclusion criteria. There were three major themes identified: 1) APNs role in reducing length of stay, 2) APNs role in reducing rehospitalization, 3) APNs role in reducing cost. Of these themes, the role of APNs in reducing LOS and preventable readmissions was defined in all the studies. Other related themes that immerged included: APNs role in increasing patient satisfaction & in improving life styles changes (Quality of Life) through promoting self-care behaviors. The systematic review showed that the role of APNs in reducing LOS and readmissions was important in the United States healthcare system.

 Discussion: The results of this systematic review are consistent with the assumption that APNs have a significant role in reducing length of stay and decreasing readmission rates. In addition, APNs have a greater influence in healthcare cost containment.

Conclusion: APNs have a critical role in reducing length of stay and decreasing readmission rates through establishing relationship-based care with patients and care coordination within interdisciplinary team members.

Keywords: Role of APNs, Readmission rate, Length of Stay, Heart Failure