Sample Nursing Paper on Nurse Leader’s Role in Reducing Readmission Rates of Patients with Heart Failure Complications

Nurse Leader’s Role in Reducing Readmission of Patients with Heart Failure Complications


The contemporary world is faced with an assortment of diseases that keep changing their symptoms, metamorphosis, and populations affected. The causalities for this proliferation of diseases on a larger number of people are blamed on a cocktail of factors such as lifestyle choices, poor healthy eating, and environmental carcinogens. However, medical practitioners and experts in the field of medicine contend that majority of these new diseases can be controlled if measures, policies, and strategies are implemented that could act as impediments to the growth or spread of some of these diseases (Institute of Medicine. 2011). Medicines and medical procedures are also some of the strategies being employed to avert these medical health issues and ailments. However, what can a nurse do to become a part of this change?

To answer this question, focus will be placed on a case analysis of the rise in cases of readmission of patients suffering from heart failure complications. According to statistics, heart failure is one of the common problems affecting the US populace. Its causalities are based on an assortment of factors most of which revolve around lifestyle choices that affect one’s health systems. For instance, aside from age, one other major causality of heart failure is the use and abuse of some drugs and poor healthy eating habits. The latter two account for at least 72% of all heart failure complications and readmissions into hospitals (Hines, Yu, and Randall, 2010). Therefore, based on this analogy, how can a nurse leader be responsive to this problem? Is it possible to reduce readmissions into hospitals based on the actions and policies implemented by a nurse leader? This will be the major assessment for this research.

Literature Review

            According to statistics, the United States admits approximately 1 million heart failure and complications patients. Further statistics indicate that approximately 50% of these patients are readmitted back into hospitals at least once within the year following the diagnosis. Over a five-year period, the mortality rate for these patients is pegged at 50%, which is a large figure that shows problems present in this sector. Is the health care system at fault, or is it the type and level of care that the patients receive at the hospitals?

Measures and policies made in the US regarding health such as the Obama Health Care Act have ensured that changes in the health care system are integrated and implemented into patient care. Previous issues such as access to medical institutions, access to insurance, number of staff and health information access has been catered to under this act. Additionally, the medical institutions in the United States have been modified and developed at both the state and county levels to cater to patients with heart failure complications through provision of the necessary equipments and skilled medical practitioners (Institute of Medicine. 2011). Therefore, it is implausible to try to form a link between the rise in cases of hospital readmissions of patients suffering with heart failure complications to such links as government policies, medical institutions, and equipment provision.

Research indicates that one of the pertinent methodologies for achieving success in any endeavor is to analyze the models being used and to generate policies and strategies to counter any issues arising. This involves making changes to polices, systems and structures guiding a particular model within the organizations, business, or project under assessment. In this context, one of the methodologies that have been identified to lead to a change in the rate of hospital readmissions of patients with heart complications is the use of direct care for these patients both within and outside of the hospitals. Further, since direct care is involved with direct consultation and interaction of patients with medical practitioners such as doctors, nurses, pharmacologists, and many others, the choice for this assessment is the role of the nurse in achieving this objective.

The nursing field is multifaceted with different nurses present with different ranks and specializations such as nurse informatics, nurse administrators, nurse educators, registered nurses, practicing nurses, CNRA nurses, among others. Assessment of this research topic from a general view of nursing proves difficult due to the large pool of information that would need to be assessed and reported. Therefore, for this analysis, focus will be placed on the role and ability of the nurse leader to effect changes to systems and policies within and outside of the hospital. These changes will be structured in a manner that ensures that readmission of patients with heart failure complications are infinitely reduced. Using examples of successful researches into this problem, as well as the nurse leader’s role in effecting successful changes to achieve the desired objective will be intricately assessed (Hines, Yu, and Randall, 2010).

A nurse leader is mandated under her nursing competency standards to lead and manage a group of nurses or departments, and generate policies and systems that would serve to improve the quality of care. Under the research topic, one of the methodology that has been identified as a mechanism for reducing hospital readmission of patients with heart complications is community policing through outpatient care. The nurse leader develops a mechanism for brining care closer to the community using outside care away from the hospital. This involves directing the nurses under her care to set up temporary care centers within the community where this type of patients can visit and receive not only medical care, but also education on lifestyle choices and healthy living. According to one study, this strategy had a reduction of 12% in the number of patients visiting the hospital with heart complications.

The nurse leader can set up policies and guidelines through which the strategy can be achieved and mechanisms for controlling the methodology that care is received including funds provisions, payment by patients, hospital liabilities, medicine provision, among others. The nurses under her flagship also need to have ample training and education to assist in this endeavor. According to the nursing competency standards, a nurse is mandated to provide education to the patient on self-care to enhance their health. Further, this analogy is defined under the middle range self care theory that advocates for nurses to use available means, equipments, and resources to educate their patients on self care both within and outside of the hospital (Peterson & Bredow, 2013).

            Education and training is another strategy that has been identified as a useful means for the nurse to assist in the reduction of hospital readmissions of patients suffering from heart complications. This education is given in the context of enhancing the level, type, and consistency of care for these patients (Bradley, 2013). For instance, field of heart complications are dynamic and changing its modus operandi, researches, and medications being given to the patients. Therefore, the nurse leader is mandated to perform research on new technologies, strategies, and medications that would help improve the quality of care for patients suffering from heart failure complications. Identifying methodologies for giving this education and training is also the prerogative of the nurse leader, in conjunction with the human resource and administration departments.

According to statistics, the level of quality care for heart failure patients has improved considerably over the past decades. Mortality rates for patients with heart failure complications have reduced by at least 23% over the past decade in the United States alone. This reduction in mortality rates is also followed closely with reduced readmissions of these patients. The reductions are as a result of improved technologies, medications and researches on enhancing the health of these patients. In consequence, it is the role of the nurses as the direct care medical practitioners to learn all these new strategies and systems and proffer the necessary level of care for their patients.

According to the role modeling theory of nursing, the nurse leader is mandated to act and behave in a manner that is responsible and productive to instill the same qualities in their staff (Peterson & Bredow, 2013). Therefore, the nurse leader can act as role model by being flexible to the changes in the field of heart correction procedures and treatment to instill a sense of responsibility among the junior staff. This sense of responsibility can come in the form of the nurse feeling the need to embrace useful and effective methodologies and strategies that have been developed to improve the health care of patients and consequently, reduce their readmission rates.

            The final strategy that can be employed by the nurse leader in the reduction of readmission rates for patients with heart failure complications is better management of the nurses. The diagnosis, treatment, and prognosis of patients by the nurses have to be done professionally and concisely. This is because there are different levels of heart failure, with lower levels only requiring the use of medications or lifestyle changes, while higher levels requiring more intricate care. Therefore, the nurse leader can ensure that nurses are fully aware of their duties and responsibilities and assessments of patients since lower level patients can receive not only care, but also education on self-care to reduce their readmission rates. This can be achieved by obtaining the medical histories of the heart failure patients, instructing them on personal care, assessing the intensity of progression of the condition, giving suitable medication, advising the patients, and individually interconnecting with them to give superior care (Bradley, 2013).    


            Readmission of patients suffering from heart failure complications is an issue that needs to be addressed due to the adverse effect it has on not only the patients, but also increased bed capacity in hospitals. There admissions rates in hospitals are believed to be caused by an assortment of factors, and it is imperative that nurses become leaders in fighting off these factors using their skills and competency standards. According to statistics, lifestyle choices are considered as the major catalyst to a deteriorating healthy population, and measures and policies have to be integrated and created to counter the effects. Nurse leaders can play a pivotal role in addressing the issues surrounding the readmission rates by using their mandate, roles, and skills to achieve better quality care for these patients.


Bradley, H. E. (2013). Hospital strategies associated with 30-day readmission rates for patients with heart failure. Circulation: Cardiovascular Quality and Outcomes. 6:444-450

Hines, P. A., Yu, K. And Randall, M. (2010). Preventing Heart Failure Readmissions: Is Your Organization Prepared? Nursing Economics. 28 (2): 74-86.

Institute of Medicine. (2011). The Future of Nursing: leading change, advancing health. Committee on the Robert Wood Johnson Foundation initiative on the future of nursing, National Academy Press, Washington, D.C.

Peterson, S. J., & Bredow, T. S. (2013). Middle range theories: Application to nursing research (3rd Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.