The incidence and prevalence of persons living with heart failure (HF) is growing in the United States. Heart failure is the most common admission in hospitals among Medicare recipients aged 65 years or older. Self-care of heart failure (SCHF) has been reported to decrease HF hospital admission rates. Elderly patients who are homebound do not have access to typical HF education and follow-up care. The purpose of this evidence-based practice (EBP) project was to implement a SCHF program intervention by nurse practitioners (NPs) with homebound elderly HF patients receiving home visits in a house call program. There were 18 sample participants in this EBP clinical project. The patient centered outcome was the number of HF hospital admissions of the project participants before and following the SCHF program. The number of HF hospital admissions pre and post the SCHF program was collected by a retrospective chart review. Each participant, therefore, served as his or her own control. In addition to the primary outcome variable, both participants and NPs evaluated the SCHF program. There was a decrease in the number of HF hospital admissions following the SCHF program; however statistical significance was unable to be determined. The participants evaluated the SCHF program by self-reporting a statistically significant increase in their SCHF behaviors. Future studies are recommended using a random sampling method in different practice settings and geographic locations using the SCHF program and its impact on HF hospital admissions. Other recommendations include measurement of SCHF behaviors as the outcome variable.
Bryant, B. (2014). Self-Care of Heart Failure in a House Call Program. . Wright State University, Dayton, OH.