This study aimed to assess the effectiveness of postdischarge follow-up calls and patient education in reducing 30-day readmission rates for congestive heart failure (CHF) patients aged 60 and older. CHF is a common and debilitating condition, especially in older adults, leading to poor health outcomes and rising health care costs. As the number of CHF patients is projected to exceed 8 million by 2030, managing high readmission rates remains a major challenge in health care. The study took place in the cardiovascular unit of a hospital, focusing on patients who had recently been discharged following a CHF-related hospitalization. A quantitative design was used, with 12 CHF patients participating in the study. Participants received educational materials about managing their health, adhering to medications, and scheduling follow-up appointments. They also received follow-up calls to monitor progress and offer support. Data were collected before and after the intervention, and statistical analyses were performed to compare 30-day readmission rates between the two groups. The results indicated no statistically significant difference in readmission rates between the pre- and postintervention groups (p = .138). This lack of significance may be attributed to the small sample size or the limited effectiveness of the intervention. The study suggests that postdischarge follow-up calls and patient education alone may not be sufficient to reduce readmissions. Case management should focus on more comprehensive interventions, improved care coordination, and exploring alternative models of care, such as community-based or integrated care teams. Further research is needed to identify more effective strategies to address CHF readmissions.

At a time when the geopolitical environment (including health care) seem chaotic and daunting, there are some timeless aspects that only the humanity of case managers can bring to the table. These "simple things" may be the most important-and are what keeps us "human".

Purpose of Study: Caring for children and youth with special health care needs can be overwhelming for families. Higher levels of need often require more extensive and coordinated support. The burden of caring for children with complex health care needs can result in negative effects for parents and caregivers over time, thus increasing the risk of poor physical, emotional, and social well-being. Nursing care coordination is an evidence-based intervention that provides families with guidance and support by delivering safe and effective care. The quality of coordination, however, can profoundly shape families’ experiences. The purpose of this study was to explore caregivers’ perceptions of nursing care coordination provided by their child’s public health plan through the lens of Kristen Swanson’s Middle Range Caring Theory. Primary Practice Settings: The study was conducted across three counties in Florida. Methodology and Sample: A descriptive qualitative design was used. A total sample of nine caregivers and parents were interviewed. Semistructured interviews were used, and data were analyzed utilizing Colaizzi’s interpretive method. Categories, subthemes, and themes were created. Results: The findings of this study highlighted caregivers’ experiences of successes and challenges with their child’s nurse care coordinators. The exploration of caregivers’ perceptions led to two major themes: Triumphs of Nursing Care Coordination and Pitfalls of Nursing Care Coordination. The two themes produced five subthemes: (a) It Takes a Village, (b) Being my Voice, (c) Third Class Citizen, (d) Being Out of Touch, and (e) Just a Title. Implications for Case Management Practice: Strengths of care coordination include enhanced access to resources, clear guidance for navigating complex health care systems, and improved understanding of treatment options, all of which help alleviate caregiver strain. While nursing care coordination offers many benefits, challenges with the current infrastructure still exist. Nurses must advocate for policies that alleviate caseload pressures, strengthen continuity of care, and identify barriers like fragmented communication and inadequate staffing. Nurses can foster a sense of support by creating forums where parents and caregivers share experiences, while encouraging decision-makers to stay informed about the challenges these families face.