Heart Failure Readmission: From the Eyes of a Patient

The purpose of this study was to explore perceptions of patients, who have congestive heart failure and who had a recent admission to the acute care setting, regarding factors that influenced their readmissions to the acute care setting, as well as to identify if there are areas of teaching that needed to be increased in emphasis or added to patient education to decrease future readmissions. The sample consisted of seven patients who had a readmission to the acute care setting and had a diagnosis of acute congestive heart failure. This qualitative study utilized semi-structured patient interviews to identify new insights and patient perceptions. The three main categories identified from the data included: A Deficit in Continuity of Care; Resilience in the Face of a Chronic Debilitating Illness; and Heart Failure Knowledge and the Role of Education in Self-Care. Despite patient determination and strength of character, readmissions were experienced by all patients. Readmissions resulted due to a lack of adherence to their heart failure self-care regimen, poor responsiveness of their bodies to heart failure management measures, and/or poor healthcare provider continuity. The data also revealed that improvements in communication among healthcare providers was a source of frustration for the interviewees. Home healthcare visits to assist with medication management and reinforcement of heart failure education are important in prevention of exacerbations. Palliative care consults to initiate advanced care planning in patients who have heart failure should be considered in the future to ensure patients’ wishes for their future are known and planned prior to end stages of heart failure. Increased communication through better use of the electronic medical record could improve the continuity of care of these patients. It is important to continue this research, expanding it to other chronic illnesses such as, chronic renal failure, diabetes, and chronic obstructive pulmonary disease. Readmissions of congestive heart failure patients to acute care facilities can cause increase health complications as well as financial costs to patients and acute care facilities. . These readmissions can lead to poor outcomes and decreased patient safety. Patients need to be given appropriate education, resources, and most importantly the self-empowerment for home care that can ultimately lead to an increased quality of life.

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