Heart failure (HF) exacerbation is a major source of hospitalization, mortality, and healthcare cost to home health agencies. Unmonitored accumulative fluid retention between skilled nurse visits, base knowledge deficits in HF pathophysiology and dietary restrictions, and lack of basic monitoring equipment such weighing scales are primary contributors to HF related hospitalizations in the home health setting. It has been discovered that early recognition of decompensating HF can reduce or eliminate HF related hospitalization, mortality, and healthcare costs associated with the management of exacerbation. When a patient is sent to the emergency room (ER) for fluid overload secondary to HF, massive costs are generated including ER transportation, ER consultation fees, hospital stay fee if admitted, and increased home health visit fees for adding additional skilled nurse visits for follow up assessments. Having a method of filling in the monitoring gaps of this patient population can reduce negative outcomes associated with managing HF in home health. The current method of monitoring weekly or bi-weekly by a skilled nurse in these complex HF patients is not best practice. For patients to receive improved and effective HF monitoring on non-skilled nurse days, additional monitoring options should be implemented. Technological advancement in modern healthcare allows the integration of technology to aide in reducing the negative impact HF exacerbation has on home health agencies. Telemonitoring (TM) heart failure in the home health setting is an evidence-based implementation option to reduce patient mortality, decrease healthcare costs, and assist healthcare providers in accessing current and relevant data for point-of-care decision making. TM devices should be installed in the homes of patients who meet the HF exacerbation risk criteria to reduce hospitalization, mortality, and healthcare costs.

Date of publication

Spring 4-19-2020

Document Type

MSN Capstone Project



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