Evaluation of Transitional Care through Home Care Services and Teaching/Learning Processes for Heart Failure Patients to Decrease 30-day Hospital Readmissions

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Hdl Handle:
http://hdl.handle.net/10755/304180
Category:
Full-text
Type:
Presentation
Title:
Evaluation of Transitional Care through Home Care Services and Teaching/Learning Processes for Heart Failure Patients to Decrease 30-day Hospital Readmissions
Author(s):
Caruso, Judith T.
Lead Author STTI Affiliation:
Alpha Tau Chapter
Author Details:
Judith T. Caruso, DNP, MBA, RN, FACHE, Judith.Caruso@shu.edu
Abstract:

Session presented on: Monday, July 22, 2013

Purpose: To evaluate if the use of transitional care services through home care services reduced hospital readmissions as compared to self-care at home for heart failure patients.'In addition,'the four key processes'of the Institute of Healthcare Improvement (IHI) Transforming Care at the Bedside How to Guidefor Patients with Heart Failure were evaluated.

Methods: Retrospective chart reviews were performed of hospital and home care records of Medicare patients discharged (N=76) from a large northern NJ medical center'January 2010-April 2010 with a diagnosis of heart failure. Through interviews/observations of work processes, the IHI four processes from admission assessment to'post-acute follow up were evaluated. SPSS version 17 was utilized'using t-tests, chi-square, and binary logistic regression.

Results: There was no statistical significant difference in hospital readmissions within 30-days between patients discharged home'to self-care'or'home care services p= 0.181. There was no significant difference in patients who received complete discharge instructions'for those not readmitted and those readmitted, p= 0.084. There'was a statistically significant difference in readmissions for patients who had had a longer length of stay (LOS) on their index admission'for readmitted patients having a mean LOS of 5.5 days (SD=2.6) compared to non-readmitted patients mean LOS of 3.5 days (SD=2.2), at p= 0.002. Hospital discharge instructions did not specify'sodium restrictions, but home care diets did. In the hospital, teach back was not routinely utilized. Weight loss was not trended to model the importance of daily weights through diuresis therapy and symptom management.

Conclusions: Opportunities for improving teaching and learning processes for all heart failure patients and families were identified based on evidence-based practices. Improvements in reducing readmissions can be measured against this data once telehealth is fully implemented in home care.'The data provided a stimulus for organizational change to improve patient care processes, improve care transitions, and'reduce readmissions prior to the impact of reduced medical payments for high readmission rates.

Keywords:
heart failure; self-care behaviors; hospital readmissions
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleEvaluation of Transitional Care through Home Care Services and Teaching/Learning Processes for Heart Failure Patients to Decrease 30-day Hospital Readmissionsen
dc.contributor.authorCaruso, Judith T.en
dc.contributor.departmentAlpha Tau Chapteren
dc.author.detailsJudith T. Caruso, DNP, MBA, RN, FACHE, Judith.Caruso@shu.eduen
dc.identifier.urihttp://hdl.handle.net/10755/304180-
dc.description.abstract<p>Session presented on: Monday, July 22, 2013</p><b>Purpose: </b> To evaluate if the use of transitional care services through home care services reduced hospital readmissions as compared to self-care at home for heart failure patients.'In addition,'the four key processes'of the <i>Institute of Healthcare Improvement (IHI) Transforming Care at the Bedside How to Guidefor Patients with Heart Failure </i>were evaluated. <p><b>Methods: </b> Retrospective chart reviews were performed of hospital and home care records of Medicare patients discharged (N=76) from a large northern NJ medical center'January 2010-April 2010 with a diagnosis of heart failure. Through interviews/observations of work processes, the IHI four processes from admission assessment to'post-acute follow up were evaluated. SPSS version 17 was utilized'using <i>t</i>-tests, chi-square, and binary logistic regression. <p><b>Results: </b> There was no statistical significant difference in hospital readmissions within 30-days between patients discharged home'to self-care'or'home care services <i>p</i>= 0.181. There was no significant difference in patients who received complete discharge instructions'for those not readmitted and those readmitted, <i>p</i>= 0.084. There'was a statistically significant difference in readmissions for patients who had had a longer length of stay (LOS) on their index admission'for readmitted patients having a mean LOS of 5.5 days (SD=2.6) compared to non-readmitted patients mean LOS of 3.5 days (SD=2.2), at <i>p</i>= 0.002. Hospital discharge instructions did not specify'sodium restrictions, but home care diets did. In the hospital, teach back was not routinely utilized. Weight loss was not trended to model the importance of daily weights through diuresis therapy and symptom management. <p><b>Conclusions: </b> Opportunities for improving teaching and learning processes for all heart failure patients and families were identified based on evidence-based practices. Improvements in reducing readmissions can be measured against this data once telehealth is fully implemented in home care.'The data provided a stimulus for organizational change to improve patient care processes, improve care transitions, and'reduce readmissions prior to the impact of reduced medical payments for high readmission rates.en
dc.subjectheart failureen
dc.subjectself-care behaviorsen
dc.subjecthospital readmissionsen
dc.date.available2013-10-22T20:30:38Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:30:38Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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