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theses

Purpose
Heart failure (HF) is a chronic disease affecting millions of Americans. It is also one of the top causes for hospital readmissions. There is currently a gap in healthcare contributing to our nation's readmission rates costing billions of dollars annually. The purpose of this project is to identify if increasing telephone communication for HF patients (pts) within the first thirty days after hospital discharge will lead to a decrease in readmissions.
Methodology
This project took place in the telemetry unit of a large urban academic medical center located in Northern New Jersey. The project involves three structured phone calls for discharged HF participants. The first call occurred within the first seventy two hours post discharge, second call occurred between the second and third week after discharge, and the final call took place before the thirty day mark. Participants were recruited for ninety days and then interviewed over the phone utilizing twenty three questions from the American Heart Association's (AHA) telephone follow-up tool. The tool seeks to identify if participants are adhering to HF self-care measures, diet, activity, and medications. Only participants discharged home were called. Amount of calls answered were then compared to readmission rates.
Results
A total of twenty one participants were recruited for the study. Four participants answered all three follow up telephone calls, three participants answered twice, three answered once, and six participants did not answer at all. Three participants were not called because they were discharged to a rehabilitation facility, one participant was not called due to being transferred to another hospital, and one other participant was excluded because they expired in the hospital. One participant was readmitted after the first phone call, another participant who did not answer any calls was readmitted, and the third readmission was a participant who was discharged to rehab. A Pearson Correlations test was utilized to test for significance where a p value less than 0.05 is considered significant. No significant relationship was identified between the amount of calls answered and thirty day hospital readmission for HF participants r (19) =0.31, p=0.169.
Implications for practice
This project did not show any significant benefit of increased telephone communication for HF participants after hospital discharge. Future clinical practice can investigate if providing education during follow up calls improves adherence to self-care measures. Participants were called assuming that education was provided by hospital staff prior to discharge. This project found that many participants failed to complete basic self-care measures. Holding an in-service for HF staff members on proper education to be delivered to patients prior to discharge may improve these outcomes.

ETD_9652

DNP

Includes bibliographical references

doi:10.7282/t3-92q9-qp51

ETD doctoral

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