My clinical rotation for NURN 236 is unique in that all the patients I care for at Union Memorial Hospital in Baltimore, Maryland , were diagnosed with heart failure (HF). HF occurs when the heart is unable to pump an adequate blood supply, leading to a lack of oxygen and nutrients in the body's tissues (Smeltzer, Bare, Hinkle, & Cheever, 2012). Approximately 670,000 Americans are diagnosed with HF each year and it is the most common hospital discharge diagnosis among older adults (Simpson, 2014). Additionally, according to the Centers for Medicare and Medicaid Services (CMS), HF is the leading cause of hospital readmission after 30 days, followed by acute myocardial infarction (AMI) and pneumonia (medicare. gov | Hospital Comparison, 2013). This information along with my weekly cohort of HF patients sparked my curiosity regarding the impacts of HF readmissions, factors for HF readmissions, and to compare suggested evidence-based practice with policies used at home. Union Memorial to reduce the 30-day HF readmission rate. Hospital readmission can impact the patient, nursing practice, the hospital, and the health care system. The patient's quality of life can be impaired physically, psychologically, and economically (Whittaker, 2014) and recurrent hospitalizations are a good predictor of increased mortality risk (Hummel, Katrapati, Gillespie, DeFranco, & Koellig, 2013). Additionally, a patient in an acute care setting is at increased risk of acquiring hospital-acquired infections such as urinary tract infections, sepsis, C. difficile, and methicillin-resistant Staphylococcus aureus (medicare.gov | Hospital Comparison, 2013). Nursing practice is affected since patients spend the majority of their stay in acute care with nursing staff at the bedside. From...... middle of document...... I hired nurses on the heart failure floor since discharge education remains one of the responsibilities. I believe that knowledge is an important factor in empowering patients in heart failure care and nurses spend almost 24 hours a day with hospitalized patients; therefore, nurses can advocate for patients by strengthening teaching. Most importantly, I believe that meeting the individual needs of the patient and establishing a good nurse-patient relationship improves trust and learning, which in the long term is very beneficial to both nursing practice and quality of the patient's life. Overall, what I have discovered about heart failure is that there is no simple solution to prevent hospital readmission for heart failure. Even with evidence-based recommended practice suggestions, hospital readmission rates for HF appear to remain high nationwide..