How Does the Use of In-home Monitoring for CHF Impact Re-hospitalization Rates? Impact on In-home Monitoring for CHF on Re-hospitalization Rates

Congestive heart failure (CHF) is one of the major cardiovascular diseases with high global incidence and prevalence in the United States. While numerous advances in evidence-based medical therapy continues to occur, congestive heart failure remains a major problem as it results in significant burden of mortality, morbidity, and costs. The United States has a prevalence of 5.8 million individuals with the condition and more than 960,000 cases annually. It is estimated that approximately one million hospitalizations linked to congestive heart failure occur annually. Most of these hospitalizations arise from worsened congestion among already diagnosed patients. The United States spends approximately $32.7 billion on congestive heart failure annually. Martirosyan et al. (2017) states that readmission rates for this condition remain high as nearly 20% of patients are readmitted within 30 days and nearly 50% within 6 months. This paper aims to present a quality improvement project toward lessening re-hospitalization rates of patients diagnosed with congestive heart failure.

Problem Discussion

Congestive heart failure (CHF) is a cardiovascular disorder characterized by periods of stability and instability (Martirosyan et al., 2017). Deterioration of CHF is linked to repeated and prolonged hospitalizations. These re-hospitalizations in turn exacerbate the condition’s prognosis while enhancing cardiovascular mortality among patients. Given the significant burden of mortality, morbidity and costs associated with this condition, healthcare providers have undertaken various measures to help in management and treatment. Current approaches are centered on early diagnosis and treatment. However, these approaches are not entirely effective in management of the condition as evident in the high rate of hospital admission and rehospitalization. Moreover, patients experience deterioration of their conditions due to various factors including poor compliance with medical therapy, natural course of the disease, and volume overload. Consequently, there is a pressing need to lessen rehospitalization of patients suffering from this condition in attempts to improve their outcomes and lessening the rising healthcare costs (Conn, Schwarz & Borkholder, 2019).

The problem is then how do we lessen rehospitalization rates of patients with congestive heart failure. Literature has shown that early diagnosis and...

Recent evidence shows that approaches like in-home monitoring would play a critical role in lessening hospital admission and readmissions for CHF. Therefore, does in-home monitoring for CHF reduce the rates of rehospitalization?
Purpose Statement

The purpose of this quality improvement project is to determine the impact of in-home monitoring for CHF on reduction of rehospitalization.

PICO Question

Identifying the PICO question is the first important step in this evidence-based, quality improvement project. The problem (P) determined in the paper is the effect of home-based monitoring on the rate of re-admission of CHF-diagnosed individuals. The intervention (I) is in-home CHF patient monitoring. Comparison (C) is: control group (non-recipients of in-home tracking). The outcome (O) serves to determine whether or not in-home monitoring reduces the rate of re-admission of CHF-diagnosed persons. Hence, the chosen PICO question is, “Does in-home monitoring (I) of CHF patients (P), reduce re-hospitalization rates (O)?”

Literature Search Process

The process of reviewing existing literature on this topic begins with a literature search using the Chamberlain College of Nursing library. The terms “heart failure” “congestive heart failure” “rehospitalization rates”, “health promotion using mHealth”, and “in-home monitoring” were utilized to commence the literature search process. Through the university’s library, numerous databases were available to generate substantial peer-reviewed articles relating to impact in-home monitoring of CHF-diagnosed patient on rehospitalization rates. Some of the databases that were utilized for this literature search were CINAHL, EBSCOHost, PubMed, Wiley and Science Direct. The search for existing literature on the topic was narrowed down to peer-reviewed articles published within the last five years. Additionally, the literature search was narrowed down to full text only articles published in HTML or PDF format and those published in English. While the search produced numerous articles, six articles were selected to support the PICO question and quality improvement project. During the literature search process, specialty organizations like American Heart Association, Alliance for Heart Failure, American College of Cardiology and American Academy of Cardiovascular Perfusion support in-home monitoring of…