Impact of APN Home Visits in Reducing Healthcare Costs and Improving Function in Homebound Heart Failure

By providing quality primary care in the home setting, nurse practitioners can treat homebound patients effectively and decrease the number of hospitalizations, 30-day readmissions, and emergency department visits. Forty patients with a diagnosis of Class III or IV heart failure who were homebound were chosen for this project. The project manager, an Adult-Gerontological nurse practitioner, made home visits to these patients on a monthly and as-needed basis throughout the 3-month project. The rate of hospital admissions, emergency department visits, and 30-day readmissions was reduced by 64%, 85%, and 95%, respectively. Patients were assessed using the Kansas City Cardiomyopathy Questionnaire (Green et al., 2000) at the initial visit and at 3 months. The scoring for physical functionality, symptom frequency, and quality of life were improved by 44%, 40%, and 54%, respectively.