Dissertation
Empowering Heart Success at Home: Nursing-Led Education for Managing Heart Failure
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Heart failure remains a leading cause of hospital admissions and readmissions, particularly among older adults in rural areas where access to specialized care is limited. To improve outcomes and align with Medicare's Hospital Readmission Reduction Program, rural hospitals must implement effective, sustainable interventions that enhance patient education and reduce avoidable readmissions.Purpose: This quality improvement project aimed to assess the impact of a nurse-led heart failure discharge education intervention on nursing knowledge, patient perceptions of discharge teaching quality, and 30-day hospital readmission rates in a rural hospital setting.Methods: Guided by the Iowa Model for Evidence-Based Practice, this four-phase project included baseline assessments of nursing knowledge and readmission data, followed by targeted educational sessions for nursing staff and standardized patient discharge teaching using a low-literacy educational brochure and reference card. Registered nurses (N=30) completed pre- and post-intervention knowledge assessments using the Heart Failure Management Assessment tool. Patient perceptions were evaluated with the Quality of Discharge Teaching Scale (QDTS) following 25 individualized teaching sessions. Thirty-day readmission rates were compared before and after the intervention using Fisher s exact test.Findings: Nurse knowledge significantly improved post-intervention (p < .001). Patients reported high-quality discharge education, with QDTS mean scores exceeding 7/10 across all domains. However, there was no statistically significant reduction in 30-day readmission rates (pre: 10%; post: 10%). Barriers included inconsistent implementation and low adherence to the intervention protocol by nursing staff.Discussion: While the nurse-led intervention successfully enhanced nurse knowledge and patient experience, it did not reduce readmission rates. This suggests that education alone may not be sufficient to impact rehospitalization and highlights the need for multifactorial strategies such as structured disease management programs and improved post-discharge support. Future work should explore sustained staff engagement, broader implementation in resource-limited settings, and the financial implications of patient-centered care initiatives.
Details
- Title: Subtitle
- Empowering Heart Success at Home: Nursing-Led Education for Managing Heart Failure
- Creators
- Susan Burda - University of Iowa
- Contributors
- Julie Stanik-Hutt (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Adult/Gerontology Nurse Practitioner (Acute Care)
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Susan Burda
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841036602771
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