Date
Spring 2024
Document Type
Scholarly Project
Department
College of Nursing
First Advisor
Amy Dievendorf
Abstract
Problem Statement: The clinical setting for this project, a 321-bed southeastern hospital in South Carolina, has an elevated re-admission rate for CHF patients of 22.67% (Ferguson, B. V.P. Quality, personal communication, October 21st, 2022), 1.57% above the Centers for Medicare Services (CMS) benchmark of 21.1% for payment reduction penalties. Purpose: Determine if post-discharge interview phone calls decrease CHF re-admission rates. Methods: A two-group pretest-posttest design will be used. Data will be collected during retrospective unit chart review, weekly chart review of patient participants, and structured post-discharge phone interviews. Inclusion Criteria: English-speaking, adult (>18 years of age) patients with no cognitive disabilities who are being discharged from the telemetry unit or discharge lounge, with a CHF diagnosis. Analysis: Hypothesis test with the null hypothesis that the proportion of readmissions was equal to the facility re-admission rate for CHF patients with the assumption of independent individuals, thereby following the binomial distribution. A significance level of 0.05 was used. Mann-Whitney U test to compare ordinal data between the two sample groups, logistic regression for MARS-5 score for readmission (if they score >80% adherent and are not re-admitted), F test for variances, T-test readmission rates, a correlation for readmission, and odds ratio (OR) for readmission for pre-post bundle implementation. Implications for Practice: Use of an evidence-based standardized post-discharge interview phone calls can identify patients with high-risk factors for re-admission, leading to expedited modifications to self-care behaviors, addressing patient care barriers, medication education/adherence or dosage adjustments, and the need for a provider office visit can mitigate the need for hospital re-admissions. This can impact facility payment reductions from the Centers for Medicare Services and lead to a decreased national healthcare expenditure
Recommended Citation
Mitchell, Regina, "Post-discharge Follow-Up Call to Impact Heart Failure Re-Admission Rates" (2024). Doctor of Nursing Practice Scholarly Projects. 59.
https://scholarcommons.sc.edu/dnp_projects/59
Rights
© 2024, Regina Mitchell