Confronting Challenges in Reducing Heart Failure 30-Day Readmissions: Lessons Learned With Implications for Evidence-Based Practice.
Racheal L Wood, Laurie A Migliore, Sandra J Nasshan and 2 others
PMID 30516340WHAT IT FOUND
Nurse-led heart failure projects used education tools and handoff protocols.
The military project did not determine 30-day readmission rates; the civilian project reported reductions without numbers.
Key findings
01The military project did not determine 30-day readmission rates because of coding discrepancies.
02The civilian project used a handoff protocol with a handoff tool, scripted phone report, room postings, and 72-hour follow-up calls, and reported reduced 30-day readmission rates during the first 3 months.
03Postimplementation staff questionnaires completed by 55% of staff suggested improved use of and satisfaction with the patient education tool.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The military project did not determine its main 30-day readmission outcome because of coding discrepancies. The civilian project reported reduced 30-day readmission rates, but no rates are given. The civilian project combined several handoff components, so the contribution of any single component cannot be separated. Neither project solicited local patient preferences. Military staff turnover was high: 80% of nursing staff and 100% of provider staff turned over during the project. Both facilities lacked robust electronic health records, data collection, and analytics support.
The easy way to misread this
Do not read this as proof that nurse-led education or handoff protocols reduce heart failure readmissions. The military project did not determine 30-day readmission rates, and the civilian project reports reductions without numbers. The civilian protocol also combined several components, so one component cannot be credited.