Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

Heart failure (HF) affects 5.7 million Americans and continues to be a leading cause of hospitalizations and deaths in the United States, posing an enormous burden on patients, families, and the health care system. Readmission rates for HF within 30 days post hospital discharge at small rural acute care facility in the southeast are consistently higher than the national average. The gap in nursing practice was the lack of up to date patient education postdischarge guidelines on HF for the socioeconomically disadvantaged, culturally diverse patient population located in this small rural town. The purpose of this project was to use an expert team to revise the HF education program and to develop a clinical practice guideline for comprehensive nurse practitioner management of these patients. The guiding practice-focused question addressed whether an expert interprofessional team could revise the HF clinical guidelines to conform with best practice, that is tailored to the low income Hispanic population to, ultimately, promote patient self-management, improve patient outcomes, and decrease readmissions for this vulnerable population. An interdisciplinary team met to review the most recent professional guidelines and the best practice literature and to develop this facility’s clinical practice guidelines. The key elements include (a) utilizing the “teach-back” technique, (b) daily repetition, (c) provision of a patient packet of bilingual information at discharge, (d) case managers ensuring a 7-day follow-up appointment, and (e) follow up phone calls post discharge. Nurse practitioner use of the updated guidelines has the potential to impact positive social change by supporting patient self-care management and preventing repeat hospitalization for patients with HF.

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