Date of Graduation


Document Type



Heart Failure, re-hospitalizations, skilled nursing facilities, quality improvement

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level



The purpose of this project was to introduce the quality improvement (QI) process to reduce re-hospitalization rates in a skilled nursing facility (SNF) in Stratford, Connecticut for patients having a diagnosis of heart failure (HF). After reviewing the data from the nursing facility for re-hospitalization rates over a three-month period, it was discovered that 22% of patients at the SNF were re-hospitalized within 30 days. Of this population of patients, 22.9% had a diagnosis or complication of HF, which is associated with the highest re-hospitalization rates. This QI project focused on HF education customized towards nursing and nursing assistant staff in order to reduce rates of heart-failure-associated re-hospitalization. The education sessions included ways to identify, prevent, and manage HF. Analysis revealed the rate of completed daily weights for patients with HF increased to 54%, the readmission rate of patients in the HF cohort reduced by 1.5%.