Objective To evaluate the value of discharge planning demand score for prediction of prolonged length of stay in older patients with chronic heart failure，and analyze corresponding nursing strategies. Methods From November 2021 to June 2022，343 older patients with chronic heart failure admitted to the cardiology wards of a tertiary hospital in Beijing were recruited，and the general data，the score of discharge planning demand and the length of stay were collected. We divided the patients into 2 groups according to the length of stay. Binary logistic regression analysis was used to explore the influencing factors of prolonged length of stay. Predictive value of discharge planning demand score for prolonged length of stay was assessed by receiver operating curve（ROC） analysis. Results There were 343 older patients with chronic heart failure included in this study. Length of stay was prolonged in 136 cases（>7 d）. The results of binary logistic regression analysis showed that living alone（OR=2.721，P=0.027） and the discharge planning demand score（OR=1.503，P<0.001） were independent predictors for pro-longed length of stay. The area under the ROC curve was 0.828（95%CI 0.781~0.876，P<0.001）；the optimal critical value was 3.5，and the corresponding sensitivity was 70.6% and the specificity was 85.5%. Conclusion The discharge planning demand score has good predictive value for the prolonged length of stay in older patients with chronic heart failure，so as to be used for early identification of high-risk individuals with prolonged length of stay.

Objective To develop an assessment scale of discharge planning demand for hospitalized elderly patients,and to test its reliability and validity. Methods The assessment scale draft was constructed by the literature analysis method and 2 rounds of Delphi consultations. The data of 242 hospitalized elderly patients was collected from October 2020 to July 2021,and the content validity,inter-rater reliability and predictive validity of the scale for unplanned readmission within 31 days were further tested. Results The scale contains 34 items in 9 dimensions. The content validity index of the scale was 0.933;the area under the ROC curve was 0.975;the confidence interval of 95% was 0.958~0.992（P<0.001）;the optimal critical value was 5.5;the corresponding sensitivity was 0.972 and specificity was 0.903;the inter-rater reliability was 0.951. Conclusion The scale of discharge planning demand for hospitalized elderly patients has good reliability and validity,and it can be used in clinical practice to assist in the identification and prediction of high-risk elderly patients for unplanned readmission.

Objective To construct a clinical nursing practice plan of discharge planning for elderly patients with chronic heart failure based on the best evidence,and to evaluate its application effects. Methods Evidence-based methods were used to systematically retrieve and summarize the best evidence for the application of discharge planning for elderly patients with chronic heart failure. Based on the best evidence,review indicators were formulated and baseline review was conducted,and promoting and inhibiting factors were analyzed. Implementation rates of review indicators,the knowledge of nurses,and the discharge readiness and self-management ability of patients were compared before and after the application of the evidence-based practice plan. Results After the application of the evidence-based practice plan,the discharge readiness scores of patients increased from（168.74±32.26） to（192.94±21.20）;the self-management scores of patients increased from（46.03±13.47） to（57.87±9.22）. The knowledge scores of nurses increased from（56.67±11.00） to（71.56±15.33）. Except for the review indicator 4 and 10,the implementation rate of the review indicators were all increased to more than 90%. Conclusion Evidence-based nursing practice can standardize the implementation of discharge planning,improve the knowledge of nurses,and contribute to the improvement of discharge readiness and self-management ability of elderly patients with chronic heart failure,which is beneficial for patients to cope with post-hospital rehabilitation.