Reducing 30-Day Heart Failure Readmissions with a Comprehensive Teach-Back Program

Abstract

Purpose: The purpose of this quality improvement (QI) project was to utilize an evidence-based heart failure (HF) checklist to guide teach-back methodology for bedside nurses on the cardiovascular progressive care unit at a hospital in Phoenix, AZ to ensure patients understand self-management concepts to reduce 30-day heart failure readmission rates. Background: Heart failure is a growing public health problem in the United States (U.S.). Nearly 7 million Americans are affected by heart failure, and the prevalence is projected to increase by 46% by the year 2030. The primary complication in disease management is hospital readmission. On average, 25% of patients with heart failure are readmitted to the hospital within 30 days. This problem was further identified at a hospital in Phoenix, AZ where an upward trend of 30-day heart failure readmissions was identified. Methodology: This project was a quality improvement effort that evaluated the implementation of the heart failure teach-back program and its impact on 30-day heart failure readmissions at a Phoenix hospital. This project used virtual education and an online pretest and posttest design to assess cardiovascular progressive care unit nurses’ knowledge, intent to use, and confidence in utilizing the heart failure teach-back program and accompanying checklist. Data was collected from the completed checklists, nurses’ responses on the surveys, and 30-day heart failure readmission data. Results: Over 90 days 11 checklists were completed. Of the patients who had a completed checklist, only two were readmitted to the hospital within 30 days of discharge. Twenty-one nurses completed the virtual education as well as the pre- and posttest surveys. There was no change in nurses’ knowledge regarding the teach-back method. There was a 20% increase in nurses’ confidence in using the teach-back method. Nurses’ intent to use the teach-back method all of the time increased by 33%. Discussion: The implementation of the heart failure teach-back program successfully supported nurses’ confidence and intent to use teach-back and the accompanying checklist, as a tool to ensure heart failure patient education prior to discharge. The results strongly support the heart failure teach-back program as an essential tool for HF patient education.