Date of Award
Summer 8-17-2024
Document Type
Scholarly Project
Degree Name
Doctor of Nursing Practice (DNP)
First Advisor
Ginger Hawkins, DNP, RN, CPHQ
Second Advisor
Daniel R. McGrath, DNP, RN, NEA-BC
Abstract
Practice Problem: Veterans hospital readmission problems are challenging, specifically in the heart failure department, which severely impacts the patient's health, mortality, family, and quality of life. Frequent readmissions increase the usage cost, hospital budget, and loss of time from providers to other veterans, and failure to meet the key guidelines of the Center for Medicare and Medicaid for improvement.
PICOT: The PICOT question that guided this project was, in veterans with heart failure and one or more frequent hospital readmissions discharged in the last 30 days(P), does the appointment of a dedicated discharge nurse practitioner as a coordinator(I), compared to standard discharge instructions (C), reduce the 30-day hospital readmission rate from the date of last discharge.
Evidence: Evidence strongly suggested and supported that the implementation of Transitions of Care Coordination with a multidisciplinary collaboration led by a nurse practitioner reduced the readmission rates within the 30-day period from the last discharge.
Intervention: The evidence-based interventions utilized with the appointment of a dedicated nurse practitioner as a discharge coordinator from the time of discharge to follow-up for 30-days while the patients are in their homes by contacting them via video, phone, text, and visiting the patient in person, and setting up follow-up appointments for primary care, specialty care while utilizing community charge nurse resources.
Outcome: Results showed a 10% reduction from 23% to 13% within a 30-day period in the heart failure department. The average readmission rate in the veteran's hospital ranged from 19% to 29%. This is a clear indication that this project has excellent future potential. Additionally, all eleven interventions were successfully implemented at a rate higher than 95%.
Conclusion: The project achieved a heart failure clinic readmission rate that was less than the hospital and national average. The reduction in the percent of 30-day readmissions was statistically and clinically significant between pre-transitional care and post-transitional care of heart failure veterans. The transitions of care 11 interventions were successfully implemented to standardize an evidence-based practice from the hospital to their home.
Recommended Citation
Reddy, D. (2024). Reducing the Incidence of Frequent Hospital Readmissions in Veterans Population. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.CFTF4505
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Included in
Cardiovascular Diseases Commons, Occupational and Environmental Health Nursing Commons, Public Health and Community Nursing Commons
Comments
Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.