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Published on: July 3, 2013
Renal failure following hospitalization for heart failure
1Amanda Kress, RN-BC, BSN, is a Board Certified Registered Nurse assigned to the 212th Combat Support Hospital and Landstuhl Regional Medical Center in Germany. She obtained her Bachelor's Degree at Indiana University, Bloomington. She is a First Lieutenant in the U.S. Army Nurse Corps.
Purpose/Goal:
The purpose of the study is to evaluate the number of patients with heart failure readmitted for renal failure to IU Health Bloomington within 30 days of hospital discharge in 2010, and to determine whether there are factors that might have been identified before the original discharge that would have prevented the readmission. The goal of the research is to identify factors from previous admissions of patients with heart failure that would have possibly predicted a subsequent admission for renal failure, so that interventions can be developed to prevent such readmissions.
Primary Practice Setting(S):
The results from this study are applicable to all primary care settings.
Methodology And Sample:
A retrospective descriptive design was employed. Subjects were patients diagnosed with heart failure in 2010 and subsequently readmitted with renal failure within 30 days of their previous hospital admission. A retrospective chart review was completed extracting the variables blood urea nitrogen levels upon patients' discharge and readmission, serum creatinine levels upon discharge and readmission, weight in kilograms upon discharge and readmission, total intake and output during the first hospitalization, diuretic medication dosage, history of renal failure, history of renal insufficiency, and death.
Findings/Conclusions:
Renal failure may be a predictable complication of heart failure. Although there are varying secondary pathophysiologies, which could account for readmission with renal failure and the severity of the renal failure, more attention should be paid to the variables identified in this study.
Implications For Case Management Practice:
Case managers can play a crucial role in identifying potential patients with renal failure and, where possible, collaborating with other health care providers to proactively preventing renal complications in patients with heart failure.
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