Management of Heart Failure in a Rural Community

Area of Science:

• Gerontology
• Cardiology
• Healthcare Quality Improvement

Background:

• Hospitalizations for heart failure (HF) among older adults in rural Western New York surpass state and national averages.
• There is a critical need for enhanced HF management strategies in rural community settings.
• Certified Home Health Agencies (CHHAs) play a vital role in managing chronic conditions like HF in older populations.

Purpose of the Study:

• To implement an evidence-based practice (EBP) guideline for heart failure (HF) management within a CHHA.
• To enhance the knowledge of interdisciplinary staff regarding HF EBP.
• To reduce hospital readmission rates for older adult HF patients.

Main Methods:

• A quantitative descriptive study design was employed.
• A convenience sample of 60 interdisciplinary staff from a CHHA participated.
• Four 30-minute educational sessions on the EBP HF guideline were delivered, with pre- and post-education knowledge assessments.

Main Results:

• A statistically significant increase in staff knowledge was observed, with post-test scores (Md = 80.00%) significantly higher than pre-test scores (Md = 60.00%) (p = .001).
• Following implementation, 66% of staff reported utilizing the EBP HF guideline for most or all older adult HF patients.
• A 4.32% reduction in all-cause 30-day rehospitalizations was achieved, decreasing from 11.39% to 7.07%.

Conclusions:

• The implementation of an EBP HF guideline effectively improved staff knowledge and care practices.
• The EBP guideline demonstrated a significant positive impact on reducing 30-day hospital readmissions for older adults with HF.
• This quality improvement project highlights the success of targeted education and guideline implementation in rural healthcare settings.