Date of Graduation

Summer 12-13-2024

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

Kaiser cohort MSN capstone

First Advisor

Cathy Coleman, DNP, RN, PHN, CPHQ, CNL

Second Advisor

Carla Martin, DNP, RN, CIC, CNL, NEA-BC, FACHE

Abstract

Problem: In 2023, a Northern California hospital's Cardiac Procedure Unit (CPU) admitted 100 heart failure patients, with 24 readmissions primarily due to inadequate self-management education. These admissions cost over $8.4 million, highlighting the urgent need for better patient education to reduce readmissions and healthcare expenses.

Context: A quality improvement initiative was launched in the CPU that handles pre- and post-cardiac care, including for heart failure patients. The unit's focus on urgent care and other priorities resulted in insufficient patient education regarding heart failure.

Intervention: From January to June 2024, the initiative implemented daily personalized teach-back education sessions on self-management. These sessions utilized an existing education kit, incorporated motivational interviewing techniques, and were tailored to each patient's health literacy level.

Measures: The primary process measure aimed to provide 90% of patients aged 65 and older with targeted education and document it in the electronic health record (EHR) within eight hours of admission. The primary outcome measure aimed to reduce the 30-day readmission rate by 20% compared to the baseline.

Results: The personalized education intervention achieved 75% of the 90% target. From January to June 2023, there were 63 30-day CHF admissions to the CPU; from January to June 2024, this number was 59. The 30-day readmissions decreased by 27% in 2024 compared to 2023.

Conclusion: Health literacy assessments and motivational interviewing improved discharge planning, reducing 30-day readmissions by 27% and potentially saving $682,162. This underscores the importance of prioritizing individualized heart failure self-management education to enhance care quality and reduce costs.

Included in

Nursing Commons

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