Variation in daily median respiratory rate identifies patients at higher risk of worsening HF in 30 days

Abstract

Methods: Using the IOWA model, our EBP team reviewed the evidence and decided to implement the Teach Back to improve our patient education process. We participated on a multidisciplinary team to develop new patient education materials that used the HF Zone tool and a new book centered on 5 key messages for HF selfcare. Learning assessment and Teach back included nurses, nurse technicians and student nurses. Further hardwiring of the practice change included review of patient education as part of daily interdisciplinary rounds and charge nurse documentations reviews. Based on the success of the practice change, key EBP Teammembers participated in the pilot for a system-wide roll-out of Teach Back, serving as trainers and competency validators for their peers. Results: The practice change was measured by a nurse survey, clinical pathway documentation audits and follow-up call data as well as HF 30 day readmission data. These process improvements contributed to reducing LOS and HF readmission rate, enabling the Health System to avoid CMS penalties for two years in a row. A key reason for the success of this programwas the levels of staff buy-in. Staff initiated the EBP project and embraced the evidence to support their practice change. Conclusion: Post implementation, HF to HF 30 day readmission rates and LOS has decreased from 16% to 3% and 5.01 to 4.11 respectively. Readiness for discharge and instructions given increased from 85% to 89.8%, and 84.6% to 89.5% respectively. The use of evidence-based strategies is clearly making a difference in the quality of our patient education and thereby improving the clinical outcomes of our HF patients.