The influences of postdischarge management by nurse practitioners on hospital readmission for heart failure

J Am Acad Nurse Pract. 2006 Apr;18(4):154-60. doi: 10.1111/j.1745-7599.2006.00113.x.


Purpose: The primary purpose of this literature review is to examine advanced practice nurse (APN)-directed versus registered nurse (RN)-directed telemanagement programs for heart failure patients.

Data sources: Research articles identified through CINAHL and OVID databases.

Conclusions: Implementing a telemanagement program directed by an APN after hospital discharge decreases the costs and frequent rehospitalizations associated with heart failure and improves the patient's quality of life. While APNs are more costly than RNs, it is important to understand that this level of provider has a more significant impact on the outcomes of patients who use the services provided in the comprehensive discharge programs.

Implications for practice: An APN-directed heart failure telemanagement program can reduce the rising healthcare costs that result from frequent readmissions. These programs can improve the quality of care given to heart failure patients while reducing the cost to the institution, the patient, and the healthcare system. When considering the number of older adults hospitalized each year with heart failure, the potential patient benefits and savings to the healthcare system resulting from APN-directed telemanagement are substantial.

Publication types

  • Review

MeSH terms

  • Aftercare / organization & administration*
  • Case Management / organization & administration*
  • Cost Control
  • Cost-Benefit Analysis
  • Heart Failure / economics
  • Heart Failure / prevention & control*
  • Hospital Charges / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Medicare / economics
  • Nurse Practitioners / organization & administration*
  • Nurse's Role
  • Nursing Administration Research
  • Nursing Evaluation Research
  • Outcome Assessment, Health Care
  • Patient Discharge
  • Patient Readmission / statistics & numerical data*
  • Reimbursement Mechanisms / economics
  • Telemedicine / organization & administration*
  • United States