Degree Name
Nursing Practice, DNP
Publication Date
4-28-2026
First Advisor
Amber Calendar
Second Advisor
Chandra Carter
Abstract
Heart failure (HF) remains a leading cause of hospitalization and readmission, with the transition from hospital to home representing a vulnerable period for patients. Variability in discharge education and follow-up scheduling contributes to poor self-management and adverse outcomes. This quality improvement (QI) project evaluated whether implementing a standardized nurse-led HF discharge protocol impacted nurses' confidence and the rate of 7–14-day transitional care management (TCM) follow-up appointments. Guided by Meleis’ Transitions Theory and Lewin’s Change Theory, a one–group pretest–posttest QI design was implemented on a cardiac step-down unit. Twelve discharge nurses participated. The intervention included a structured education session and the use of a standardized discharge protocol incorporating patient education and predischarge TCM scheduling. Nurse confidence was measured using the Susan Grundy Confidence Scale, and TCM outcomes were collected through electronic health record review. Results demonstrated a statistically significant improvement in nurse confidence at six weeks (z = -2.91, p = .004). The rate of scheduled appointments increased from 78.0% to 83.9%, but the difference was not statistically significant (χ²(1) = 0.30, p = .584). Implementation of a standardized discharge protocol improved nurse confidence and demonstrated clinically meaningful trends in follow-up scheduling. These findings support nurse-led, workflow-integrated interventions to enhance transitional care processes in HF populations and similar high-risk populations.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Elrod, Jessi-Ann, "Implementation of a Nurse-Led Discharge Protocol to Impact Nurse Confidence and Optimize Transitional Care Management" (2026). Doctor of Nursing Practice Projects. 339.
https://arch.astate.edu/dnp-projects/339
