Optimizing Heart Failure Management by Enhancing Discharge Instructions for Heart Failure Patients: A Quality Improvement Project

Abstract Heart failure (HF) remains as one of the leading causes of heart disease mortality in the United States (Rizzuto et al., 2022). Despite advancements in treatment, HF-related readmissions remain high. Optimizing discharge education is an essential strategy for enhancing self-care management and reducing hospital readmissions. A Las Vegas hospital recognized gaps in providing effective discharge education including lack of educational resources, training, and protocol adherence. This quality improvement project aimed to enhance nurse discharge education practices to HF patients and improve their self-care and self-efficacy. A nurse training seminar was conducted based on the Heart failure care for Enhancing self-management At home by Reinforcing discharge education with Teach-back method (HEART) program followed by implementing a standardized discharge education protocol. Nurse knowledge and compliance were assessed using pre- and post-training evaluations and a standardized discharge checklist. Patient self-care and self-efficacy were measured on discharge and one week post-discharge using a scale and index. Results showed that there was a statistically significant improvement in knowledge and compliance scores of nurses post-training. Patients also improved significantly in self-care and self-efficacy one week post-discharge. Therefore, the outcomes of the study reflect the achievement of the project objectives, ultimately demonstrating the effectiveness of the project in enhancing discharge education practices. This project emphasizes the importance of evidence-based discharge guidelines and enhanced nurse competency in potentially improving patient outcomes and reducing hospital readmissions. Sustainability plans and further study with necessary improvements are recommended to further validate findings and possible adoption of the protocol in other settings

Optimizing Heart Failure Management by Enhancing Discharge Instructions for Heart Failure Patients: A Quality Improvement Project It is currently estimated that heart failure (HF) affects around 6.2 million adults in the United States, with associated annual costs to the economy projected to be $30.7 billion (Rizzuto et al., 2022). Even though there have been advances in the treatment of HF, most HF-related hospital admissions are still readmissions. The mean readmission rate for persons with heart failure across the country was 21%, according to Rizzuto et al. (2022). A study by Rice et al. (2018) explored the impact of nurse-led one-on-one patient education on medical expenditures, readmission rates, and quality of life (QoL) on patients with HF who lived in community settings. The study found that nurse-led one-on-one patient education programs for HF patients lower hospitalization and readmission rates and are economically beneficial (Rice et al., 2018). In University Medical Center, nurses across various cardiology departments were interviewed to find out if there are policies and protocols on discharge orders. All the nurses reported that there were no specific guidelines for discharging patients in the different departments. However, they reported using the standard CARE NOTES application of the hospital integrated into the Electronic Health Record to find the information required. Nurses and unit clerks performed critical roles in both collecting data and implementing the project. The data on the process of discharge for heart failure patients could be found from various organizational lines. However, every nurse appeared to have a unique process in which they discharge patients. One of the gaps discovered from the data is the lack of a specific flowchart or patient education procedure. There was a deficiency in targeted discharge education tailored to HF patients. In