Evaluating the Impact of a Telemedicine Protocol on the Quality of Life and Readmission Rates in Heart Failure Patients

The purpose of this research study was to examine the impact of a protocol outlining a telemedicine visit one-week and two-weeks post-discharge on quality of life and 30-day readmission rates in patients with heart failure. Heart failure (HF) is the sixth-leading source of mortality nationwide, and there is a 50% five-year survival rate with a diagnosis of heart failure. HF is the paramount cause of hospitalizations and 30-day readmission rates among aged adults in the continental US. Telemedicine has been shown to positively impact quality of life and hospital readmission rates in patients with HF. The ACE Star Model was utilized in this study. The five points of the model include discovery, summary, translation, integration, and evaluation. The model was utilized to guide the transformation of practice through implementation of evidence-based telemedicine visits. A quasi-experimental design was used with a telemedicine intervention at one- and two-weeks post-discharge for patients with HF. Quality of life was measured for all participants pre- and post-intervention using the Minnesota Living with Heart Failure Questionnaire. Data was analyzed through Wilcoxin and t test statistical tests. Results indicated there was no significant difference in the mean total score from pre- to post-intervention; however, the mean total score did decrease from 46.30 pre-intervention to 36.15 post-intervention, indicating less heart failure symptoms. There was statistical significance in two categories of the Wilcoxon "makes you short of breath" and "making you tired, fatigued, and low on energy." There was no decrease in pre- and post-intervention hospital readmission rates. Potential limitations included a small sample size and implementation of the study during cold and flu season, which could have impacted hospital readmission rates. Clinical relevance of telehealth requires further validation using further research, specifically in the population of patients with HF. This research study is applicable to advanced practice nursing as telehealth offers a cost-effective and convenient method to provide healthcare services to older adults.