Reducing Readmissions for Patients Hospitalized with Congestive Heart Failure

Morgan B. Morgan, Walden University

Abstract

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's

theory was to determine if there would be an increase in the nurses' knowledge about

using the teach-back process to assess learners' understanding after completing the

education module. Thirty-two registered nurses participated in the education, and a paired

t test was used to determine if there was a significant difference (p < .05) in the nurse's

knowledge by comparing the pre- and posttest results. A statistically significant

difference was seen in the scores between the pre- and posttest with a p value of 0.0002

suggesting that nurses' knowledge about teach-back increased after participating in the

teach-back education module. The outcome of this project has the potential to prepare

nurses to evaluate the patients' understanding of their self-care instructions before

discharge. This project has the potential for positive social change by preparing patients

to provide proper self-care when discharged from the hospital, thereby improving their

health outcomes, decreasing the rate of 30-days readmissions, and decreasing health care

costs for the hospital.