Emergency Nurses’ Perceived Confidence in Participating in the Discharge Process of Congestive Heart Failure Patients From the Emergency Department: A Quantitative Study

Abstract

Introduction: Adults with exacerbated heart failure (HF) who present to the emergency department (ED) generally are readmitted. However, Hispanic HF patients are more likely to be admitted than Whites. Studies show the importance of nurse-led interventions in the ED discharge process, but registered nurse (RN) confidence in performing discharge tasks has not been assessed. Greater nurse confidence leads to improved task performance, and potentially reduced HF readmission, lowering cost of care. This study aimed to gain insight into ED RNs’ perceived self-confidence in discharge tasks with stabilized HF patients. Method: A self-report survey on perceived self-confidence was analyzed in a prospective, cross-sectional quantitative study. Participants were 22 RNs at an ED in a largely Hispanic community in New York City. Results: Moderate levels of confidence were found for performing various tasks with HF patients. Only 6 of the 21 nurses reported feeling “very confident” about discharge tasks. Twenty (90.1%) believed guidelines would increase their confidence. Conclusion: These findings can help in developing nurse-driven strategies to foster confidence in the discharge of stabilized HF patients from the ED.