Nurse-Led Discharge Planning and Readmission Rates Among Elderly Cardiac Patients

Résumé

Hospital readmission among elderly patients following cardiac events remains a persistent quality concern, with discharge transition gaps frequently implicated as a contributing factor. This study evaluates the effect of a structured nurse-led discharge planning protocol on thirty-day readmission rates among elderly patients discharged following cardiac hospitalization. The protocol assigns dedicated discharge nurses responsible for medication reconciliation, teach-back verification of self-care instructions, and scheduled follow-up contact within seventy-two hours of discharge, compared against standard discharge procedures at a comparable unit. Patient-level outcomes were tracked over a six-month implementation period, alongside qualitative interviews with participating nurses regarding protocol feasibility within existing staffing constraints. Results show a meaningful reduction in readmissions attributable to medication-related complications specifically, while readmissions unrelated to medication management showed less pronounced difference between groups, suggesting the protocol's benefit operates primarily through improved medication self-management rather than broader recovery support. Nurses reported that teach-back verification, though time-intensive, was the component most consistently linked to patient-reported confidence in self-care. These findings support targeted expansion of nurse-led discharge protocols emphasizing medication reconciliation as a cost-effective readmission reduction strategy for elderly cardiac populations.