Defense Date

7-18-2023

Graduation Date

Summer 8-5-2023

Submission Type

DNP Manuscript

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Yvonne Weideman

Committee Member

Venkatraman Srinivasan

Keywords

heart failure, diuretic, diuretic kit, home health, reducing heart failure readmissions, heart failure self care

Abstract

Background and significance: heart disease was the number one cause of death in the United States in 2021, with 696, 962 deaths (Leading Causes of Death, 2022). There are about 6.2 million individuals in the U.S. total with heart failure (Kilgore et al., 2017). About one-quarter of patients with heart failure are readmitted within thirty days of discharge, while one-quarter of hospital readmissions are preventable. Between 2010-2017, over seven million patients were admitted for heart failure in the United States. Eighteen percent had a readmission within thirty days and thirty-one percent had a readmission within ninety days (Khan et al., 2021). Within the Allegheny Health Network, about thirteen percent of patients were admitted with heart failure in 2021 (Kwansy, 2022). To reduce hospital readmissions in my health system, heart failure patients discharged with home health services received a home heart failure diuretic rescue kit (See Appendix A). The protocol for the kit called for the nurse to follow a specific stepwise protocol for administering diuretic therapy and potassium supplementation (See Appendix B). Purpose: The purpose of this project is to evaluate the effectiveness of the home heart failure intravenous diuretic kit to prevent the readmission of heart failure patients to the hospital within a thirty-day period. The goal is to establish if the kit helped reduce hospitalization to reduce economic burden and improve morbidity and mortality. Methods: The home heart failure kit and protocol were implemented on February 21, 2022. The data that was considered for evaluation includes ordering the kit through the electronic health record, distribution of the kit from the pharmacy to the patient, utilizing the kit and the heart failure protocol at home by the home health nurses, and the knowledge of heart failure symptoms by the patient.

Language

English

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