Abstract
For older adults, heart failure (HF) has the highest 30-day hospital readmission rate of any chronic illness. Despite research into strategies to reduce readmissions, no single program has emerged as sustainable. The purpose of the current study was to test a researcher-developed home health nurse HF intervention (CareNavRN™) on 30-day readmission rates, HF knowledge, self-care, and quality of life (QOL) among 40 older adults transitioning home. Home health nurses received specialized HF training and visited patients once per week at home for 4 weeks. The control group (n = 21) had six readmissions (29%) and the intervention group (n = 19) had three readmissions (16%); however, the results were underpowered and statistically nonsignificant. Pre-/post-surveys demonstrated significant improvement in HF knowledge (p = 0.043), self-care confidence (p = 0.003), and QOL (p < 0.001) in the intervention group. CareNavRN is a promising approach to improve outcomes during transition from hospital to home for patients without access to a comprehensive disease management program. [Journal of Gerontological Nursing, 46(2), 32-40.].
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