Part 1: Table
Part 2: Summary
Hospital readmissions are a perfect indication of the quality of care within healthcare settings. They are usually attributed to missing links in the nursing process which are attributed to professional neglect or ignorance, policy loopholes or even patient-based aspects that do not confine to the requirements of desired quality of care. In the contemporary healthcare setting, and more particularly within the US, the Affordable Care Act adoption led to a situation where readmission rates as well as hospital acquired illnesses were tied to the quality of care as key indicators. This was within the concept that if healthcare facilities and professionals place more focus on quality and safety of care in a holistic manner, then these can be managed and the costs of care can significantly decline. For patients who have been diagnosed with Heart Failure (HF), hospital readmissions have been a common occurrence. This has been attributed more directly to an existing knowledge gap within the patient group on the self-care abilities as well as self-management of their condition in post-discharge. In this regard, the integration of patient education programs has been studied as a potential method that can help increase self-care and self-management for these groups and ultimately reduce the occurrence of readmissions (Kommuri, Johnson, & Koelling, 2012). Such education programs can be accomplished from the very first day that a patient is admitted all the way to post-discharge and then followed up with education sessions to help augment these techniques in the patient. Such follow-up can be accomplished via telephone conversations with the nurse and continued for a significant period of time; say five months (Xiao-Hua et al., 2013). Similarly, the care team can opt for the teach-back methods of education where a diverse team of healthcare professionals come together and develop a lean system where networking is the foundation of achieving effective and reliable patient education (Peter, Robinson, Jordan, Lawrence, Casey & Salas-Lopez, 2015).
For HF patients and the imminent correlation to the high rates of readmission as well as poor transitions to homecare, the need for more education beyond the standard form of education that is afforded to other patients is the key to managing the high rates of readmissions. Weight management techniques, appropriate dietary techniques, counseling, dosage up-titration as well as adherence to medication are the major elements/goals of patient education (Basoor et al., 2013). According to Matthews, Johnson & Koelling (2007) while patient education is the key to minimizing readmissions for HF patients, there is a need to tailor the education to the specific needs of each patient. Essentially, this is based on the knowledge that these needs could significantly differ along economic, social, psychological and physiological aspects. This is because a standardization of the patient education programs makes a poor assumption that all these HF patients live in similar conditions which is entirely not true. A common agreement across a majority of research is that in order to reduce the rates of readmissions in HF patients, patient education should be a mandatory goal. Similarly, there is an agreement that the integration of a multidisciplinary team helps ensure that a holistic care plan and patient education plan is designed that meets the specific needs of each patient. The only major differences across the research is that some researchers are of the view that patient education should begin within the initial days of admission, while others prefer follow-up education and others with the view that combining both strategies is a better method. The goals of patient education however, remain unaltered; it is all about improving self-care abilities (Koelling, Johnson, Cody & Aaronson, 2005).
References
Basoor, A., Doshi, N. C., Cotant, J. F., Saleh, T., Todorov, M., Choksi, N., Patel, K. C., DeGregorio, M., Mehta, R. H. and Halabi, A. R. (2013), Decreased Readmissions and Improved Quality of Care With the Use of an Inexpensive Checklist in Heart Failure. Congestive Heart Failure, 19: 200–206. doi: 10.1111/chf.12031
Koelling, T. M., Johnson, M. L., Cody, R. J., & Aaronson, K. D. (2005). Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation, 111(2), 179-185.
Kommuri, N. V. A., Johnson, M. L., & Koelling, T. M. (2012). Relationship between improvements in heart failure patient disease specific knowledge and clinical events as part of a randomized controlled trial. Patient Education and Counseling, 86(2), 233–238. http://doi.org/10.1016/j.pec.2011.05.019
Matthews, J. C., Johnson, M. L., & Koelling, T. M. (2007). The impact of patient-specific quality-of-care report cards on guideline adherence in heart failure. American heart journal, 154(6), 1174-1183.
Peter, Debra D., Robinson, P., Jordan, M., Lawrence, S., Casey, K., & Lopez, D. (2015). "Reducing readmissions using teach-back: enhancing patient and family education.".The Journal of nursing administration (0002-0443), 45 (1), p. 35.
Xiao-Hua, W., Jing-Bo, Q., Yang, J., Guo-Chong, C., Jun-Hua, Y., Jian-Hong, P., & Xin, Z. (2014). Reduction of Heart Failure Rehospitalization Using a Weight Management Education Intervention. Journal Of Cardiovascular Nursing, 29(6), 528-534 7p. doi:10.1097/JCN.0000000000000092
