Nurse-Led Heart Failure Quality Collaborative for Rural Hospitals

Heart failure is a growing public health concern, affecting more than five million Americans, including 22 percent of all patients discharged from rural hospitals, and costing $33.2 billion annually. The high cost is largely due to the underuse of proven therapies, especially in rural hospitals where nursing staff may lack the expertise to translate research into practice.

Twenty-four hospitals in the Mid-Atlantic area formed a collaborative to improve the quality of care for heart failure patients through evidence-based nursing practices. The toolkit they implemented included:

  • A heart failure fact sheet, scientific articles and nurse education models.
  • Heart failure admission order set.
  • Heart failure discharge checklist.
  • Standardized patient education booklet and recommended videos.
  • Recommended smoking cessation counseling based on Health and Human Services guidelines.

An interim evaluation at six months showed that most (91%) of the hospitals had implemented a multidisciplinary team to guide heart failure improvement, and 45 percent had accelerated heart failure-specific nurse education. Yet 36 percent of the hospitals stated that they had encountered physician barriers to implementing improvements.

The authors conclude that quality collaboratives provide a network to share best practices in rural hospitals to improve heart failure patient outcomes.