Discharge readiness in heart failure

Patients with heart failure (HF) face the challenge of living with a chronic condition. The transition from the hospital environment to home requires diligent attention to ensure that the patient is ready for discharge. Being ready to go home or "discharge readiness" is vital to the successful transition of HF patients. Discharge readiness is related to the discharge outcomes for the hospital and is an indicator of the need for additional discharge transition support interventions in the home setting. The purpose of this study was to evaluate the level of readiness for discharge in the HF patient and examine if further patient education prevents readmission within thirty days. Readiness for discharge encompasses personal status, coping, knowledge, and expected support prior to the hospital discharge. A descriptive comparative study was conducted with patients divided into two groups, one receiving the Readiness for Hospital Discharge Scale (RHDS) and additional education on HF and the other group standard nursing care with no intervention. The RHDS captured the patient's perception of discharge readiness. The study was conducted in an urban academic medical center. Patients (N=50) with a diagnosis of HF were recruited. Six patients from both study groups were readmitted to the hospital within the thirty day period post discharge. Over sixty percent of the patients had income levels below $20,000 and had a previous hospital stay within the last six months. Arthritis and respiratory problems were the most frequently reported co-morbid conditions. With the emphasis on reducing HF readmissions, it is imperative that nurses are cognizant of the patient's discharge readiness prior to discharge. Nurses need to examine approaches in preparing the patient for a successful transition to the home environment that takes into consideration recent hospitalizations, income levels and co-morbid conditions.