The Determinants of Nurses’ Competencies in the Prevention of Heart Failure Patient Readmissions: A Systematic Review

Abstract

This structured, PRISMA-informed narrative review examines determinants of nurses’ competencies relevant to preventing hospital readmissions among adults with heart failure (HF). Forty-nine distinct empirical journal reports published from 2016 to 2025 were synthesized. Eleven reports directly examined nursing knowledge, preparation or professional roles; the remaining thirty-eight principally evaluated nursing-related patient education, monitoring or transitional services. Evidence on competence antecedents emphasizes HF-specific knowledge, professional education, experience, continuing training and opportunities to coordinate care. Intervention studies suggest that structured teaching, caregiver participation and integrated follow-up can improve self-care and sometimes reduce rehospitalization; however, randomized comparisons also report no significant readmission benefit. Knowledge scores and intervention outcomes are not equivalent indicators, and few studies link measured competence of individual nurses with their patients’ subsequent admissions. Differences in interventions, settings, control conditions and follow-up horizons preclude a defensible pooled effect estimate. The review proposes a three-level evidence framework and identifies gaps in competency measurement, implementation fidelity, and the linkage of nursing practice to patient outcomes.