Date of Award

Spring 4-30-2023

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing

First Advisor

Dr. Jennifer Stewart-Glenn



Nurse-led education heart failure education for symptom monitoring and management


Problem Statement: Over six million adults in the United States have heart failure (,2020). According to the Agency for Healthcare Research and Quality (AHRQ), almost 20% of heart failure patients hospitalized are readmitted under 30 days (AHRQ, 2013). The American Heart Association (AHA) (2022) recommends a visual symptom tracking tool for self-care symptom monitoring to increase patient adherence and reduce readmissions. Despite this recommendation, the AHA tool for symptom monitoring is not fully incorporated into the discharge of every heart failure patient often because of nursing management time constraints, and limited resources for designated discharge nurses.

Purpose: The purpose of this DNP Project is to evaluate the feasibility of the utilization of the AHA symptom tracking tool and to determine the effect of nurse-led education for heart failure patients that incorporates the AHA symptom tracking tool into discharge education regarding self-care behaviors and symptom monitoring. Measurements of the effects include patient adherence to self-care behaviors and 30-day readmission rates.

Methods: In this pilot study, patient education was provided to participants by the nurse researcher before discharge incorporating the AHA tool for symptom monitoring and management, daily weight, medication adherence, sodium restriction, and follow-up with primary appointments. A follow-up phone call 7-10 days after discharge was made to participants to determine adherence to self-care behaviors, symptom monitoring, and again at approximately 21 days post discharge.

Analysis: In comparing hospital readmission rates to heart failure patients who received only standard discharge teaching, the analysis revealed a there was not a significant statistical difference in readmission rate between the groups. However, the use of the AHA tool was found to be effective with a small sample when combined with follow up phone calls. Further research is indicated on a larger scale to demonstrate the correlation between the education intervention, adherence to self-care behaviors and readmission rates.

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