Purpose: The purpose of the study was to determine the impact of the discharge education plan on the 30 day heart failure (HF) hospital readmission rates of elderly patients.
Research Question: What was the impact of the discharge education plan including medication adherence, dietary discretion, daily exercise tolerance, daily weight recording, recognition of any early symptoms of worsening HF and early follow-up plan with the physician in reducing the 30 day HF hospital readmission rates of the elderly patients?
Research Hypothesis: The discharge education plan including medication adherence, dietary discretion, daily activity tolerance, daily weight monitoring, recognition of any early symptoms of worsening heart failure, and early follow–up with the physician will reduce the 30 day heart failure hospital readmission rates of elderly patients.
Background: HF is one of the most common diagnoses and indications for hospitalization among adults over 65 years in United States (Pang, Komajda, and Gheorghiade, 2010). HF admission results in 6.5 million hospital days annually. In 2010, the total cost of care for patients with HF was 39.2 billion dollars (Gheorghiade, Vaduganathan, Fonarow, and Bonow, 2013). About two million Medicare beneficiaries are readmitted within 30 days of release from the hospital each year, costing Medicare 17.5 billion dollars in additional hospital bills. It is reported that elderly patients with HF are at increased risk for early readmission as a result of behavioral factors such as medication non–adherence, dietary indiscretion, exercise intolerance, drug and alcohol abuse, inadequate access to follow-up care, and poor transition of care (Gheorghiade, et al., 2013).
Design and Methods: A retrospective, non–experimental, and descriptive chart review was used in this study. The quantitative data, using convenience sampling, selected charts of patients with a diagnosis and readmission of HF within 30 days of discharge from the hospital between May 2012 and June 2013, was reviewed.
Findings: A chi square statistic was used to investigate whether distributions of categorical variables differ and also compare the tallies or counts of categorical responses between the six independent variables. The significant results of the Chi square test for goodness of fit was found only for daily weight monitoring (p=0.0372) and with activity intolerance (p=0.0123). The test compared theoretical (expected) values to experimental (observed) values to determine whether the differences between these values are due to chance (sampling error) alone. The components of the discharge education plan that could not be tested were early recognition of worsening symptoms, early follow–up with the physician and medication non-compliance because of the low frequency counts of <5, and thus we cannot assume that the data follows a rough normal distribution. Therefore, the hypothesis was not supported.
|Commitee:||Lee, Jueng W., Marshall, Brenda, Matza, ILene|
|School:||The William Paterson University of New Jersey|
|School Location:||United States -- New Jersey|
|Source:||DAI-B 75/11(E), Dissertation Abstracts International|
|Keywords:||30 day, Congestive heart failure, Discharge instructions, Heart failure, Readmission rates|
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