Date of Award

Summer 7-22-2024

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Dr. Theresa Pape, PhD, MSN, RN, CNOR-E, CNE

Second Advisor

Dr. Lee Petrarca, DNP, RN, FNP-C

Abstract

Practice Problem: In one hospital, the readmission rates and emergency room visit for patients who are diagnosed with heart failure (HF) was increasing.

PICOT: Among veterans who are hospitalized for HF (P) does the enrollment into a care coordination program for these veterans (I) compared to current practices (C), reduce the hospital readmission rates and emergency department visits (O) within 10-weeks (T)?

Evidence: The literature supports the idea that home telehealth as a home monitoring program for patients who have chronic diseases such as heart failure (HF) and has had success in patients with hypertension amongst patients. Transition strategies from inpatient to home are important to prevent hospital re-admissions.

Intervention The project included enrolling patients who have HF, in an evidence-based home telehealth care coordination program, intensive case management or specialty case management programs within 48 hours of being discharged from the hospital or the emergency department.

Outcome: Those who enrolled in the case management program reduced the emergency room visits and hospitalizations by 75.86 %, with a total of 29 visits prior to enrollment and down to seven post intervention. The result of the two-tailed paired samples t-test was significant based on an alpha value of .05, t(20) = 2.85, p = .010, showing a significant difference in the 8-week period.

Conclusion: This EBP project shows that enrolling patients who have recently been hospitalized for HF, in a home telehealth or a case management program was effective at reducing readmissions in an 8-week period. The results were both statistically and clinically significant.

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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