Nursing-Sensitive Process Indicators Predicting 30-Day Readmission in Chronic Heart Failure

Area of Science:

• Nursing Science
• Cardiology
• Public Health

Background:

• Unplanned 30-day readmissions for chronic heart failure (CHF) pose challenges to healthcare quality and patient safety.
• Identifying predictive nursing-sensitive indicators is crucial for improving patient outcomes.

Purpose of the Study:

• To identify nursing-sensitive process indicators during hospitalization and at discharge that predict 30-day hospital readmission in adults with CHF.
• To inform targeted nursing interventions aimed at reducing readmission rates.

Main Methods:

• Retrospective case-control study involving 640 adult CHF patients.
• Data collected on nursing-sensitive indicators: in-hospital falls, fall-risk identification, discharge education, post-discharge follow-up, medication knowledge, polypharmacy, and dosing frequency.
• Comparison between readmitted cases (n=320) and non-readmitted controls (n=320).

Main Results:

• In-hospital falls, fall-risk identification, poor medication knowledge, polypharmacy, and complex medication schedules were associated with increased 30-day readmission odds.
• Structured nursing education at discharge significantly reduced the likelihood of 30-day readmission.

Conclusions:

• Nursing-sensitive process indicators independently predict 30-day readmission in adults with CHF.
• Strengthening fall prevention, enhancing medication education, and improving discharge preparation are actionable nursing interventions.
• Targeted nursing interventions can improve discharge readiness and reduce preventable readmissions.