Self-care in Heart Failure Hospital Discharge Instructions—Differences Between Nurse Practitioner and Physician Providers

• Published in: Journal for nurse practitioners Vol. 14; no. 1; pp. 18 - 25
• Main Authors: David, Daniel, Howard, Elizabeth, Dalton, Joanne, Britting, Lorraine
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Inc 01.01.2018; Elsevier Limited
• Subjects: Activities of daily living; Cardiology; Content analysis; discharge instructions; Documentation; Evidence-based nursing; Health care policy; Heart failure; Hospitals; Intensive care; Medical records; Mortality; nurse practitioner; Nurse practitioners; Patients; Physicians; Primary care; Readmission; Self care; Theory; heart failure; nurse practitioner; self-care; discharge instructions
• ISSN: 1555-4155; 1878-058X
• DOI: 10.1016/j.nurpra.2017.09.013

Patients with heart failure (HF) are at risk for frequent readmission potentially due to self-care deficits. Medical doctors (MDs) and nurse practitioners (NPs) both provide discharge instructions. However, each type of provider may emphasize different elements of care. The aim of this study was to analyze and compare the content of the documentation of 50 discharge instructions of heart failure patients written by NPs and MDs. Compared with MDs, NPs placed greater emphasis on symptom identification, and were more likely to advise and schedule follow-up appointments with primary care and cardiology providers rather than advising an appointment was needed without scheduling one. •Provider differences in documentation of discharge instructions for heart failure patients are described.•Nurse practitioner and medical doctor providers emphasize different aspects of heart failure self-care.•NPs were more likely to document a specific date/time for follow-up appointments.•Improvement is needed for both nurse practitioners and doctors to address deficits in instructions.•Instruction is needed in diet, exercise, and avoiding triggers for heart failure exacerbation.