Hospital Readmissions

Working in a renal/urology medical-surgical unit, it is a challenge for both the nursing staff and nursing administration to have readmissions due to fluid and electrolyte imbalance from patients with ESRD and CHF. In my own experience, patients who have been in and out of the hospital for the past six months to a year are at a higher risk of acquiring nosocomial infections resulting in a weaker immune system to an already compromised one, as well as longer hospital stay. Readmissions from these patients pose as a physical, emotional and financial strain to both patients and/or their families. Additionally, readmissions within 30 days for patients with CHF poses as an additional cost for hospitals as there is reduced Medicare payments for Inpatient

The importance of preventing and managing chronic diseases, which include renal failure and cardiovascular diseases, along with their risk factors are emphasized by the Department of Chronic Disease and Health Promotion of the World Health Organization (Desroches, Lapointe, Ratté, Gravel, Légaré, & Turcotte, 2013). However, there is evidence in literature showing a gap of knowledge in the kinds of educational interventions being considered as most effective in compliance to dietary regimen. The study by Desroches et al., 2013 states that there are limitations to their study including that being a short duration, low quality and adherence measures varied widely (Desroches et al., 2013) Hence, these limitations assisted in the generation of research questions, which are: 1) Which educational interventions being used show reliability in compliance or adherence to dietary regimen; 2) What are the detrimental factors contributing to low compliance to dietary regimen among patients with ESRD and CHF; and 3) Can a study performed in a longer length of time produce a higher rate of compliance to dietary regimen among patients with ESRD and