J Korean Acad Nurs Adm.  2023 Mar;29(2):141-154. 10.11111/jkana.2023.29.2.141.

Development of Discharge Nursing Service Model for Heart Failure Patients

• Park SH
• Lee JH
• Jang YS
• Han SY
• Kim YA
• Oh EG

• KMID: 2549347
• DOI: http://doi.org/10.11111/jkana.2023.29.2.141

Abstract

Purpose
This study aimed to develop a discharge nursing service model (DNSM), including one that accounts for the role of discharge nurses and the discharge nursing process for heart failure patients (HFP) with a high readmission rate, and to verify its clinical feasibility.
Methods
As a methodological study, DNSM was established through a literature review and benchmarking, and the clinical feasibility of the expert group was confirmed through the Delphi technique.
Results
Through a literature review and the benchmarking, the DNSM for HFP was formulated. The nine core competencies are professional nursing practice, education, counseling, advice, ethical decision-making, research, collaboration, evidence-based practice, and leadership. In addition, fifteen criteria and 42 indicators were added as detailed items. The discharge process comprised five stages and 25 processes identified by analyzing and integrating the content of discharge nursing intervention required for HFP by period-from hospitalization to 30 days after discharge. Content validity was verified by the twofold application of the Delphi technique, and the average CVI was over 0.92.
Conclusion
In terms of quality management, developing an efficient system or service is necessary to prevent readmission, and developed DNSM should be continuously revisioned and reinforced through follow-up studies.

Keyword

Heart failure; Patient discharge; Patient readmission; Nursing process; Nursing services