Management of Heart Failure in a Rural Community
In rural Western New York, hospitalizations of patients over 65 years of age with heart failure (HF) exceed state and national levels, demonstrating a need for improved management of older adult HF patients in rural communities. The aim of this project was to implement an evidence-based practice (EBP) guideline for HF management at a certified home health agency (CHHA). The objective was to increase CHHA interdisciplinary staff knowledge and to implement an EBP HF guideline to improve care and reduce hospital readmission rates. This quality improvement project used a quantitative descriptive study design, with a convenience sample of 60 CHHA interdisciplinary staff. A series of four 30-minute educational sessions were provided to the staff regarding the EBP HF guideline. Data were collected using pre- and posteducation testing to assess knowledge. A 3-month evaluation was completed to assess implementation along with readmission data pre- and postimplementation. Of the 60 interdisciplinary staff who received the EBP HF guideline education, 17 participants completed both the pretest and posttest. Results demonstrated a statistically significant increase in knowledge from the pretest (Md = 60.00%) to the posttest (Md = 80.00%) (p = .001). In the 3-month follow-up survey, 66% of the staff reported using the EBP HF guideline on “most” or “all” older adult HF patients. The organization had a 4.32% reduction in all-cause 30-day rehospitalizations from 11.39% to 7.07% following the implementation of the EBP HF guideline.