Hospitals readmit many patients with congestive heart failure (CHF) within 30-days of discharge, which can lead to financial sanctions for hospitals unable to maintain 30-day readmission rates below specified limits. CHF is a progressive, debilitating, and ultimately end-stage chronic illness with recurring, multifaceted symptoms that may lead to rehospitalizations, decreased quality of life, and increased death rates. Adherence to discharge instructions is one area where patients with CHF can exercise independent control of their disease and can prevent readmissions. This qualitative phenomenological study explored the lived experiences of 10 culturally diverse patients in 2 south-Florida hospitals who met the criteria for the purposeful sample. The researcher made 3 separate consecutive home visits, modeled on Newman’s health as expanding consciousness (HEC) theory. Seven semistructured, open-ended phenomenological interview questions probed patients’ perceptions of the central phenomenon of hospital readmissions. NVivo 10® software facilitated the data-analysis process. Interviews with 10 culturally diverse research participants revealed 3 themes conveying their lived experiences during and after hospital discharge and readmissions: Disabling Adherence (challenges to adhering to discharge instructions and self-management), Healthcare-System Conundrum (difficulty navigating health system follow-up care), and Dehumanized Caring (perceptions of a lack of health-provider caring and communication). The nurse researcher-participant experience suggested the possible benefits of the HEC nursing model to prevent readmissions. These findings are important to leaders, nurses, and health professionals in the improvement of 30-day readmission outcomes.

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University of Phoenix: Dissertation submitted in fulfillment of requriements of Doctor of Management in Organizational Leadership Degree.

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Full-Text available to BHSF community. Also available at ProQuest.


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