Date of Award

Summer 2018

Document Type

DNP Project Restricted

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Jackie Owens DNP, RN, FNP-BC

Committee Member

Angela Coladonato DNP, RN, NEA-BC

Abstract

Hospital readmissions are a problem for heart failure patients and poor self-care contributes to exacerbation and hospitalization. The purpose of this DNP project was to assess self-care of heart failure patients and informal caregivers upon hospital readmission. A prospective, descriptive survey design was used to study 49 patients and 27 caregivers. Self-care was assessed using Self-Care of Heart Failure Index version 6.2, which measures self-care maintenance, management and confidence. Scores, demographic and clinical data and presence of caregiver were examined as determinants of self-care and readmission. The majority of patients were male (61%), married (45%); males were older than females; patients with caregivers were older. The mean number of hospital readmissions in the previous 12 months was 3.47. Patients and caregivers performed poorly with mean scoressubscales, patients’ scores ranged from 53.57 to 64.01; caregivers’ scores ranged from 61.15 to 63.45. Correlation procedures did not support the hypotheses that those with better self-care or caregivers would experience fewer readmissions. Multiple linear regression was used to explore relationships between self-care measures, clinical and demographic variables and hospital readmissions, to compare patients with and without caregivers, and create a predictive model for determinants of self-care. The hypothesis that patients with better self-care would experience fewer readmissions was not supported; however, support was demonstrated for the hypothesis that those with caregivers would have higher levels of self-care, although only in management skills. Low self-care efficacy in this sample illustrates opportunities for patient and caregiver education and support.

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