A clinical problem I am seeing during my practicum is the readmission rates. These readmission rates could be due to a variety of underlying issues such as language barriers, failure to understand discharge teaching, insufficient time to adequately provide discharge instructions or noncompliance. The Centers for Medicare and Medicaid (CMS) have put fourth measurements to help decrease hospital readmission rates. The CMS defines readmission as “an admission to a subsection hospital with in 30 days of a discharge from the same or another subsection hospital” (CMS, 2017). Three main diagnosis that were identified by CMS for having high readmission rates are, acute myocardial infarction, heart failure, and pneumonia (CMS, 2017). In my experience working on the cardiac unit there are many times we see patients readmitted for heart failure due to a failure to comply with their medication regimen. The increased readmission rates have an effect on nursing.     Two nursing implications of increased readmissions, specifically related to heart failure are improved knowledge and instruction about heart failure, and coordinating care after the patient has been discharged. Nurses must be further educated on the process of heart failure and how to better educate their patients prior to discharge. This can mean further education for nurses and increased time spent by the hospital to provide the education for the staff. The coordination of care post discharge is important to decrease the readmission rate for heart failure patients. A way to encourage patients to follow discharge instructions is to check in with them on a regular basis after discharge, this might be done through a phone call or a visit. I know that my hospital was trying to implement a process when an RN will call the patient at different intervals following discharge to check in with the patient. I think that both furthering an RN’s education about heart failure and implementing a system in which patients are checked in with after discharge could reduce the readmission rates of heart failure patients.       Reference:     Centers for Medicare and Medicaid (CMS). (2017). Readmissions Reduction Program (HRRP). Retrieved from: payment/acuteinpatientpps/readmissions-reduction-program.html

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