Exploring Factors Influencing Heart Failure Readmission

Sowa, Mee Young, Nursing Practice - School of Nursing, University of Virginia
Keeling, Arlene, School of Nursing, University of Virginia

Heart Failure (HF) readmission is complicated and influenced by multiple factors. Few studies have directly investigated patients’ perspectives regarding reasons for HF readmission. The purpose of this descriptive qualitative study was to examine the experiences of persons who were readmitted to a mid-Atlantic medical center for all causes within 30 days of discharge from the initial hospitalization with HF. Nine HF patients over 50 years of age were recruited to complete a semi-structured interview (HSR #17345). The participants described the reasons they believe they were readmitted and they shared their insight into how they believe they could have prevented readmission. A review of the medical record was performed to collect demographic, clinical, diagnostic, and post discharge activity. The interview utilized five open-ended questions on etiology, self-care, and decision-making on seeking care, education/treatment, and input for prevention. Several themes emerged: inevitable or unavoidable readmission due to the severity of the condition; optimal self-care adherence; symptom monitoring and taking action with family and provider’s support; heart failure readmission decision appreciated as a shared result of well-coordinated transitional care; appreciation for evidence based programs; and patient satisfaction regarding self-care teaching. The readmission trend in the current study reflected the challenges from the patients’ severity of condition and population characteristics that are faced by an academic teaching hospital. The nine participants voiced satisfaction, which exemplified the high quality of inpatient care (teaching, optimization of treatment, and discharge planning) and seamless transitional care from collective evidence based interventions, although their readmissions were not prevented. The findings of this study can assist clinicians by including patients’ perspectives in evidence based interventional strategies for reducing HF readmission.

DNP (Doctor of Nursing Practice)
readmissions, heart failure, qualitative research, patient perspectives, transitional care
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