Decreasing Thirty-Day Readmissions for Heart Failure Patients

Systematic Review: Decreasing Thirty-Day Readmissions for Heart Failure Patients by Willybroad Che MS, University of Texas Arlington BS, University of Texas Arlington Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2020 Abstract Heart failure (HF) patients have a 20-25% hospital readmission rate within the first month of discharge. Patients experiencing HF often have a decline in health resulting in frequent hospitalizations and encumbering symptoms including dyspnea, fluid retention, and orthopnea. HF is a common condition in nursing homes and accounts for a significant proportion of resident transfers to emergency departments. HF is considered one of the costliest diagnoses in the United States, estimated to cost the healthcare system billions of dollars annually. The purpose of this systematic review was to provide a synthesis of evidence-based literature on the current recommendations and strategies for reducing 30-day readmission for nursing home HF patients and to recommend effective strategies to address the problem. Kurt Lewin’s force field theory was used to frame this project. A review of CINAHL, Medline, and ProQuest Nursing & Allied Health Source resulted in 7 evidence-based articles. Evidence was appraised and graded according to the levels of evidence identified by Fineout-Overholt and colleagues. Results of this systematic review demonstrated that home telemonitoring was unable to reduce HF readmission within 30-days of discharge. The strategies of utilizing structured homeHeart failure (HF) patients have a 20-25% hospital readmission rate within the first month of discharge. Patients experiencing HF often have a decline in health resulting in frequent hospitalizations and encumbering symptoms including dyspnea, fluid retention, and orthopnea. HF is a common condition in nursing homes and accounts for a significant proportion of resident transfers to emergency departments. HF is considered one of the costliest diagnoses in the United States, estimated to cost the healthcare system billions of dollars annually. The purpose of this systematic review was to provide a synthesis of evidence-based literature on the current recommendations and strategies for reducing 30-day readmission for nursing home HF patients and to recommend effective strategies to address the problem. Kurt Lewin’s force field theory was used to frame this project. A review of CINAHL, Medline, and ProQuest Nursing & Allied Health Source resulted in 7 evidence-based articles. Evidence was appraised and graded according to the levels of evidence identified by Fineout-Overholt and colleagues. Results of this systematic review demonstrated that home telemonitoring was unable to reduce HF readmission within 30-days of discharge. The strategies of utilizing structured home visits, improving nurse-physician communication, and improving staff knowledge on HF showed a reduction of HF patient readmission within 30-days of discharge. Recommendations from this SR can improve the quality of life of HF patients and their families, and reduce the high financial burden to patients, their families and the