Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Shelley Y. Hawkins, PhD, APRN-BC, FAANP (Chair), Cynthia D. Connelly, PhD, RN, FAAN, Ruth Bush, PhD, MPH


health literacy, heart failure, readmission, telehealth


Aim: Technology holds a great potential to improve the quality of health care delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure.

Rationale: TH has been successfully utilized by agencies to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning.

Methods: Utilizing the OASIS-C database, a retrospective analysis was conducted examining 22-months of heart failure patient data from one home care agency in southern California. Seventy patients receiving TH were compared to patients who received usual home care nursing services.

Results: No major differences in baseline socio-demographics were found between the two groups. While receiving home health care services, the non-TH patients had a 21% all-cause hospital re-admission rate, compared to the home TH patients with a 10% all-cause re-admission rate. Statistical differences were found between groups on the variables of fall risk, vision, smoking, shortness-of-breath, the ability to bathe and take oral meds, along with having been discharged from a skilled nursing facility in the past 2weeks.

Document Type

Dissertation: Open Access