Nurses' heart failure discharge planning part II: Implications for the hospital system

The purpose of this interpretive descriptive study was to understand bedside nurses' motivation and decision-making during discharge planning for patients with HF on a 48-bed telemetry unit.

Heart failure (HF) discharge planning interventions have largely excluded the contributions of bedside nurses.

Fifteen nurses were interviewed. Coding was done using NVivo and thematic analysis was completed.

This paper is the second in a two-part series which presents separate results of one interpretive descriptive study delineating the factors that impact bedside nurses' HF discharge planning. This paper presents how nurses' lack of time, competing priorities, and hospital policies affect nurses' HF discharge planning. In addition to the previous report (part I) of how nurses felt more motivated during HF discharge planning when they had time to establish a personal connection with patients, nurses reported being motivated when they had time to individualize HF education and did not feel rushed to complete discharge planning tasks.

Findings from this study suggest that patients with HF may benefit if bedside nurses are afforded the support to effectively assess patients' discharge needs and educate them. A shift in organizational practice is needed, such as employing HF nurse educators to lead bedside nurses in a more structured method of HF education delivery, requiring discharge planning as a component of each shift's work, and promoting bedside nurse involvement in HF discharge planning decision-making within interdisciplinary teams.