Minimizing Congestive Heart Failure Readmissions from the Nursing Home Through Focused Nursing Education

The purpose of this quality improvement project was to determine if congestive heart failure (CHF)-specific education and protocols for nursing home (NH) staff could improve their knowledge and reduce hospital readmissions through nursing knowledge application for patients 65 years of age or older residing in a nursing home. The project took place in two nursing homes in South Central Texas. The project used a quasi-experimental, two-group, design with retrospective chart review. Nursing CHF knowledge was measured at the intervention (n=15) and control (n=12) facilities using the Nurses’ Knowledge of Heart Failure Education Principles Survey Tool (NKHFEP) pre- and post-education intervention. The education program consisted of a 2.9 Continuing Education unit, Texas Nurses’ Association approved, course on CHF management in the nursing home setting. Chart reviews for hospital readmissions and nursing application of CHF-specific interventions were performed 3-months pre- and post-education program. Nurses at the intervention facility demonstrated improved CHF knowledge when compared to the control group: Treatment M=94, Control M=79.3 (t(25)=4.785, p< .001, d=1.91. Readmission rates decreased at the intervention facility and remained equivocal at the control facility. Nursing documentation of interventions improved at the intervention facility and remained low at the control facility. An evidence-based, CHF-specific educational program provided to front line NH staff of a central Texas NH, significantly improved nurse knowledge and resulted in clinically significant improvements in nurse application of CHF interventions and decreased CHF-related readmissions to the hospital, when compared to a control group.