A Hybrid Transitional Care Program

Daley, Cathleen M.

doi:10.1097/hpc.0b013e3182018838

Cited by 13 publications

(48 citation statements)

References 8 publications

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“…Of the 23 studies, 15 had a predominantly white sample (ranged from 39% to 98%), 6 had a predominantly African American sample (ranged from 39% to 68%), 1 had a predominantly Hispanic sample (64%), and the only study that was conducted outside the United States presumably had a 100% Asian sample. Of the 23 studies, 4 were experimental 21,22,28,31 (2 studies explored the effect of the same intervention; however, they explored different HF outcomes 21,22 ). On top of assessing health literacy, 5 of the 19 observational studies explored potential predictors of health literacy, 27,32–35 5 explored the relationship between health literacy and HF outcomes (eg, hospitalization, mortality, quality of life), 26,29,30,36,37 8 explored both the predictors of health literacy and the impact of health literacy on HF outcomes, 23,24,38–42 and the remaining study merely assessed the health literacy of its sample.…”

Section: Resultsmentioning

confidence: 99%

Health Literacy and Heart Failure

Cajita

Han³

2016

Journal of Cardiovascular Nursing

217

160

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Background Low health literacy affects millions of Americans, putting those who are affected at a disadvantage and at risk for poorer health outcomes. Low health literacy can act as a barrier to effective disease self-management; this is especially true for chronic diseases such as heart failure (HF) that require complicated self-care regimens. Purpose This systematic review examined quantitative research literature published between 1999 and 2014 to explore the role of health literacy among HF patients. The specific aims of the systematic review are to (1) describe the prevalence of low health literacy among HF patients, (2) explore the predictors of low health literacy among HF patients, and (3) discuss the relationship between health literacy and HF self-care and common HF outcomes. Methods A systematic search of the following databases was conducted, PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus, using relevant keywords and clear inclusion and exclusion criteria. Conclusions An average of 39% of HF patients have low health literacy. Age, race/ethnicity, years of education, and cognitive function are predictors of health literacy. In addition, adequate health literacy is consistently correlated with higher HF knowledge and higher salt knowledge. Clinical Implications Considering the prevalence of low health literacy among in the HF population, nurses and healthcare professionals need to recognize the consequences of low health literacy and adopt strategies that could minimize its detrimental effect on the patient's health outcomes.

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Section: Resultsmentioning

confidence: 99%

Health Literacy and Heart Failure

Cajita

Han³

2016

Journal of Cardiovascular Nursing

217

160

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“…[22][23][24][25] This intervention was reserved for patients who returned to community living immediately after discharge. Transitional care programs routinely employ telephone follow-up as one aspect of the program when transitioning patients from hospital to home.…”

Section: Postdischarge Telephone Contactmentioning

confidence: 99%

A Quality Improvement Plan to Reduce 30-Day Readmissions of Heart Failure Patients

Simpson

2014

Journal of Nursing Care Quality

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An evidence-based quality initiative to decrease heart failure 30-day readmissions was implemented at a hospital in Florida. Heart failure education and postdischarge telephone contact were provided to patients determined to be at high risk of readmission using risk stratification tools. The rate during the project decreased 13% as compared to the same time period in the previous year and 8.5% from the 2012 year to date rate.

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“…According to Daley (2010) , transitional care services to patients requiring care across multiple settings can positively impact outcomes. Longitudinal case management was utilized with collaboration between the inpatient case manager and the outpatient nurse practitioner.…”

Section: Case Management and Social Servicesmentioning

confidence: 99%

A Heart Failure Initiative to Reduce the Length of Stay and Readmission Rates

White

Hill

2014

Professional Case Management

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Implementation of evidence-based heart failure guidelines, improved interdisciplinary coordination of care, patient education, self-management skills, and transitional care at the time of discharge improved overall heart failure outcome measures. Utilizing the longitudinal model of care to transition patients to home aided in evaluating social support, resource allocation and utilization, access to care postdischarge, and interdisciplinary coordination of care. The collaboration between disciplines improved continuity of care, patient compliance to their discharge regimen, and adequate discharge follow-up.

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A Hybrid Transitional Care Program

Abstract: A successful transitional HF program can reduce readmissions, length of stay, cost of hospitalization, and mortality rates. Adaptation of this model elsewhere should be a consideration.

Cited by 13 publications

References 8 publications

Health Literacy and Heart Failure

Health Literacy and Heart Failure

A Quality Improvement Plan to Reduce 30-Day Readmissions of Heart Failure Patients

A Heart Failure Initiative to Reduce the Length of Stay and Readmission Rates

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