Type of Document	Thesis
Author	Davis, Amy S
Author's Email Address	amy.davis@tmh.org
URN	etd-11142005-155838
Title	Preventable Readmissions for Heart Failure: A Clinical Nurse Specialist Case Manager's Challenge
Degree	Master of Science
Department	Nursing, School of
Advisory Committee	Advisor Name Title dennise tucker Committee Member Jeanne Flannery Committee Member Sandra Faria Committee Member
Keywords	Heart Failure Case Management
Date of Defense	2005-10-27
Availability	unrestricted
Abstract Betty Neuman’s Systems Model (1985), the Integrated Case Management Model (2004), and the Clinical Nurse Specialist (CNS) Spheres of Influence (1998) were blended together to create the theoretical framework that guided this study. This quasi-experimental study utilized both retrospective and prospective data to investigate the efficacy of a Clinical Nurse Specialist Case Manager (CNS CM) Intervention on reducing the 7-day and 30-day readmission rates of patients diagnosed with heart failure. The overall findings of this study, following the programmatic intervention, indicate that there was a decrease in both the 7-day and 8-30-day readmission rates of patients with the primary diagnosis of heart failure (HF). The results of this study were not statistically significant, but were of clinical and of financial importance. There was a difference of 11 total readmissions that is equivalent to a savings of approximately $44,000.00, as a result of the CNS CM intervention. Of interest was the fact that both the pre-intervention and intervention patient groups were particularly similar with respect to demographic and personal health characteristics. Given the similarity of the groups, it is more plausible that the decreases seen in the readmission rates were directly related to the CNS CM intervention versus unknown, confounding variables. Although increases in case management and social work documentation as well as home health care consults were observed, these percentages are still sub-optimal.
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