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Heart failure (HF) contributes to the highest frequency of 30-day hospital readmissions out of all causes, raising the already significant risk for adverse outcomes and costs. This quality improvement project sought to determine if 60 minutes of standardized inpatient education and scripted telephone followup, administered by staff nurses trained in HF, could reduce 30day hospital readmissions, thus improving outcomes and selfmanagement in this population.
Heart failure (HF) is the fastest growing cardiac disease, and it is associated with high mortality, significant disease burden and poor quality of life, and imposes a high cost to the healthcare system (Centers for Disease Control and Prevention [CDC], 2019). About 5.7 million Americans have HF and over 800,000 new cases are diagnosed each year (Albert, 2016; CDC, 2019). It is attributed to one in nine deaths, and about half who develop the disease will die within 5 years of diagnosis (CDC, 2019). HF also contributes to the highest frequency of 30-day hospital readmissions out of all causes, raising the already significant risk for adverse outcomes and costs (Baptiste et al., 2016; Dumitru & Baker, 2016).
Heart failure is increasingly being recognized as a disease of older adults, and those ages 65 and older have the greatest risk (Lazzarini et al., 2013). Twentyseven percent of Medicare beneficiaries are readmitted within 30 days of their initial hospitalization, and 6-month readmission rates are as high as 50% (Dumitru & Baker, 2016). Up to 80% of the costs associated with HF are attributed to hospitalizations and readmissions (American Heart Association [AHA], 2019). Research suggests that more than half of these readmissions are preventable and result from suboptimal selfcare and inadequate inpatient and discharge management (Baptiste et al., 2016), strongly emphasizing the need for quality improvement (QI).
Patient education promotes HF knowledge and self-care, prevents hospital readmissions, and improves patient adherence, thus making it a transitional care priority (Casimir et al., 2013; Kommuri et al., 2012; Vreeland et al., 2011). Patients with HF require ongoing education to manage their disease and adhere to guideline-directed recommendations (Albert, 2016). Disease-specific education is a core measure for assessing hospital quality by the Joint Commission and the Centers for Medicare & Medicaid Services (CMS) (Vreeland et al., 2011). The AHA (2019) recommends at least 60 minutes of...