Date of Award

Fall 12-2-2022

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Sarah M. I. Cartwright, DNP, MSN-PH, BAM, RN-BC, CAPA, FASPAN

Second Advisor

Angelica Adriano, DNP, NP-C, NE-BC

Abstract

Practice Problem: The lengthy distance required to access specialty care, the overall higher cost of SCI/D care, complications associated with SCI, and the potential negative impact of shortened hospital stays are all compelling reasons to use telehealth technologies to deliver specialty services for medical issues.

PICOT: The PICOT question that guided this project was in adult spinal cord injury patients with chronic disease receiving primary care at a spinal cord injury center (P), how does the implementation of a remote patient monitoring home telehealth for SCI patients recently discharged from acute-care setting (I) compared to the usual practice of one post-discharge follow up phone call at 7 days (C), improve early recognition of patient deterioration to prevent acute care rehospitalization (O) within 30 days of discharge (T).

Evidence: Spinal Cord injury patients are at risk for developing complications after injury. Paststudies have demonstrated the effectiveness of telehealth to prevent rehospitalization, which suggests the potential of telehealth on post-discharge follow-up care.

Intervention: Implement remote patient monitoring home telehealth for SCI patients meeting the criteria for high-risk rehospitalization.

Outcome: The pilot project results have a positive correlation with the reduction of 30-day hospital readmission rates for SCI patients participating in the RPM. During the pilot period, no readmissions occurred for the RPM participants, whereas those who declined participation were readmitted at a rate of 22%. Clinical significant findings of improved outcomes and reduced 30-day readmissions are supported through this pilot project.

Conclusion: The project utilized the Johns Hopkins evidence-based model’s three-step PET framework and Roger’s diffusion of innovation change theory to support reduced rehospitalization for SCI patients through RPM.

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

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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