Dissertation
The impact palliative care consults have on readmission rates for patients diagnosed with heart failure
Doctor of Nursing Practice (D.N.P.), Drexel University
Jun 2016
DOI:
https://doi.org/10.17918/etd-6825
Abstract
Background and Purpose: In the United States, approximately 5.8 million individuals have heart failure (HF) with newly diagnosed cases annually. Patients diagnosed with symptomatic HF continue to have mortality and readmission rates approximating 5% - 30%, respectively. Palliative care is one transitional care process which may reduce readmission rates from one third to one half. The aim of this quality improvement (QI) project was to evaluate the impact of palliative care (PC) consults on 30-day readmission rates for patients with the primary diagnosis of HF. Methods: A retrospective chart review of HF patients treated at an academic medical center between July 1, 2014 and July 1, 2015 was performed. Data extracted from the medical records included documentation of a PC consult and presence of a 30-day readmission after index HF admission. Demographic and descriptive variables included: sex, age, race, insurance type, and severity of illness. Descriptive statistics and chi-square analysis were conducted to identify the differences in 30-day readmissions by PC consults. Results: A total of 1,032 patient records were retrieved and 222 excluded for not meeting inclusion criteria; the remaining 810 records were used for analysis. The sample was primarily men (59.8%, n = 484), Blacks (46.4%, n = 376), and between the ages of 50 - 64 (44.9%, n = 364). The 30-day readmission rate for the total sample was 16.7%. There was a difference between 30-day readmission rates for those who did not receive a PC consult (15.9%) and those patients who did receive a PC consult (25%). Out of 135 reported 30-day readmissions for HF, 87.4% did not receive a PC consult and 12.6% did receive a PC consult. The results were not statistically significant (p = 0.54). Clinical Implications and Recommendations: Readmission rates were lower in those who received a PC consult however, this was not statistically significant. Further evaluation of PC consults and interventions in patients with HF is warranted.
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Details
- Title
- The impact palliative care consults have on readmission rates for patients diagnosed with heart failure
- Creators
- Patricia A. Smith - DU
- Contributors
- Rose Ann DiMaria-Ghalili (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Doctoral Nursing; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 6825; 991014632531504721