Graduation Semester and Year
Fall 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Tiffany Trent
Abstract
Objectives: To implement standardized food insecurity screening using the Adult Food Security Survey Model (AFSSM) and evaluate whether individualized dietitian-led nutrition education and community resource referrals improve nutritional health knowledge and reduce 14-day post discharge emergency department visits among adults hospitalized with heart failure (HF).
Methods: This eight-week quality improvement project was conducted in a 220-bed acute care hospital in Texas. Adult patients with a primary diagnosis of HF were screened using the AFSSM. Patients screening positive for food insecurity were referred to a dietitian for individualized nutrition education based on pre-test results and patient-specific needs. Patients also received information about community resources. Nutritional health knowledge, community resource utilization, and ED visits were assessed during a 14-day post-discharge follow-up call.
Results: Of 119 HF patients identified, 118 (99%) completed the screening, and 29 (25%) screened positive for food insecurity. Of these 29 patients, 11 (38%) received dietitian education, and five (17%) completed all intervention components. Four completed both knowledge assessments. Three demonstrated lower post-test scores, and one demonstrated improvement. Six (21%) patients visited the ED within 14 days of discharge. Limited intervention completion prevented meaningful statistical analysis.
Conclusions: Standardized food insecurity screening identified unmet needs among hospitalized HF patients. Barriers to implementation included short hospital stays, staffing limitations, and difficulty reaching patients after discharge. Integrating screening, automated dietitian referrals, individualized education, and improved follow-up communication into existing workflows may improve sustainability and support more comprehensive HF care.
Keywords
Heart failure, food insecurity, social determinants of health, nutritional health knowledge, individualized nutrition education, discharge planning, quality improvement
Disciplines
Nursing
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Ballard, Erica, "Implementation of a Food Insecurity Assessment Tool to Improve Health Knowledge Outcomes in Heart Failure Patients" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 35.
https://mavmatrix.uta.edu/nursing_dnpprojects2/35