Date of Graduation

5-2016

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor

Smith-Blair, Nan

Reader

Lee, Peggy

Second Reader

Agana, Carol

Abstract

Abstract

Congestive heart failure (CHF) is a chronic disease that impairs the quality of life (QoL) of patients and is associated with both high hospital readmission rates and healthcare resource utilization such as emergency services. This study proposed use a student led transitional care program in providing home care to NYHA functional class II and III CHF patients. It evaluated the impact of the program on their quality of life as measured by the Minnesota Living with Heart Failure Questionnaire© (MLWHFQ), the percentage of patients requiring readmission to the hospital within 30 days of initial hospitalization, and healthcare utilization. Thirty-six patients completed the MLWHFQ prior to and post enrollment to a 14-week transitional care program. Descriptive statistics were used to characterize the data obtained using the MLWHFQ. A paired samples t-test was used to determine if there was a statistically significant difference between the means of the the pre- and post- MLWHFQ assessments. No statistically significant difference was noted between the total MLWHFQ scores pre- and post-survey t (34) = 1.554, p= .13. Subscale evaluation on the physical and emotional dimensions were also analyzed with not statistical significance. Examination of pre- and post-mean scores however did demonstrate a decrease from pre- to post survey assessments for the total MLWHFQ (pre- M= 45, SE +4.9; post- M= 39, SE +4.6) values as well as the physical (pre- M= 19.86, SE +1.97; M= 17.31, SE +1.93) and emotional dimensions (pre- M = 7.74, SE +1.46; post- M =6.63, SE + .947) of perceived quality of life. Examination of individual questions reveal that perceptions of participants’ quality of life decreased in terms of their ability to perform activities such as household chores, working in the yard, and participating in recreational activities and hobbies. Additionally, they had more difficulty with concentration and memory, feeling out of control which impacted their socialization with family and friends. This led to a higher degree of perceived social isolation. Of the participants, 9.5% utilized acute care services (emergency department) while 4.7% required readmission to the hospital within 30 days following their initial hospitalization. The lower rates for healthcare utilization may have been in part due to the student led transitional care program monitoring patients on a weekly basis allowing the cardiac advanced nurse practitioner to respond and address clinical changes in a timely manner.