Analysis of Clinical, Social, Transitional Care, and Medication Reconciliation Factors Associated with 30-Day Adult Heart Failure Readmissions
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Authors
Brodecky, Bridget
Bredenkamp, Nancy
Ruiz, Joel
Walker, Emily
Goetz, Jeff
Issue Date
2014-06-03
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Poster
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Objective: Heart failure (HF) is a chronic clinical syndrome that has been identified to cause high rates of mortality, morbidity, and increased health care costs. Heart failure patients frequently experience hospitalizations due to acute exacerbations. A high percentage of readmissions have been reported to occur soon after discharge (Anderson, 2013).|Methods: This descriptive study was a retrospective chart review of 36 adult heart failure patients at a Midwest heart and vascular specialty hospital readmitted to the hospital within 30 days of discharge. The study’s aim was to determine if the hospital met the 96% medication compliance on discharge and 96% compliance with scheduling a 2-week follow-up based standards for adult HF patients are being implemented upon hospital discharge that may reduce morbidity, mortality, and a 30-day hospital readmission. Social, transitional, and clinical care factors were examined. In addition, heart failure specific medication components were examined. After the information and data was collected, indicators for 30-day hospital readmission in the HF population were identified.|Results: Patients ranged in age from 60 to 85+ years of age with 72% of the patients were male. The majority of patients re-admitted were initially discharged home (70%). 61% of patients did not have a scheduled two-week follow-up at initial discharge. All but one patient had five or more comorbidities. At initial discharge no prescribed medications met the 96% benchmark. Also, the benchmark for scheduled two-week follow-up was not met (40%).|Implication for Practice: The American Heart Association has since released updated HF guidelines and future studies should use these as the variable inclusion criteria. Implications for the nurse practitioner working in primary care are to be familiar with the new HF guidelines and assure their patients are receiving the necessary interventions post-discharge. In addition, frequent review of patients HF management is necessary to assure interventions have not been excluded inadvertently.
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