Date of Graduation


Document Type


Degree Name

Bachelor of Science in Nursing

Degree Level





Smith-Blair, Nan

Committee Member/Reader

Holloway, Ginger

Committee Member/Second Reader

Henderson, Jaye



Over 5 million Americans have been diagnosed with heart failure, and that number is growing. This disease is burdensome to the patient as it lessens their quality of life and to the healthcare system due to costliness and frequent readmissions. This study aims to evaluate if a student nurse led transitional care program can increase patient self-care confidence, in turn reducing 30 day hospital readmission rates. Twenty patients completed the Self Care of Heart Failure Index before and after a 14-week transitional care program. These reported data were compared using a paired samples t-test. There was not a statistically significant difference in pre- and post- self-care maintenance with a mean difference of 3.51 (95% CI, -5.89 to 12.91), t (17) = .788, p= .44, nor was there a statistically significant difference in self-care confidence with a mean difference of 8.34 (95% CI, -1.71 to 18.39), t (17) = 1.751, p= 0.98. Only 5 participants were included in measuring self-care management, with a mean difference of 18 (95% CI, -58.85 to 22), t (5) = -1.223, p= .29. The implementation of a transitional care program did not increase reported self-care maintenance, management, or confidence. Transitional care is complex and is most effective when provided at home with trained professionals for an extended amount of time. Despite the absence of a large increase in self-care, 30-day hospital readmissions occurred among the study group at a rate of 4.7%, compared to the 25% rate commonly found in the literature. Transitional care models have the capacity to improve patient care and health outcomes.