Reducing Length of Stay and Hospital Readmission for Orthopedic Patients: A Quality Improvement Project.

discharge education length of stay nursing readiness for discharge readmission total joint arthroplasty

Journal

Journal of doctoral nursing practice
ISSN: 2380-9426
Titre abrégé: J Dr Nurs Pract
Pays: United States
ID NLM: 101685366

Informations de publication

Date de publication:
29 Oct 2021
Historique:
entrez: 30 10 2021
pubmed: 31 10 2021
medline: 31 10 2021
Statut: aheadofprint

Résumé

Transitioning patients from the hospital to home after a total hip or knee arthroplasty is challenging. Severe pain, comorbidities and complex medication regimes have the potential to delay readiness for discharge, increase length of stay (LOS), and cause readmissions. The goal of this practice improvement project was to improve patient readiness for discharge after total joint arthroplasty to reduce LOS, prevent emergency department (ED) visits, and prevent hospital readmissions. This quality improvement project was guided by the Iowa Model and implemented a prepost program implementation evaluation design. Nurses incorporated the Registered Nurse Assessment of Readiness for Hospital Discharge Scale (RN-RHDS) to guide and evaluate discharge education efforts. The focused education cohort demonstrated significantly decreased LOS and decreased readmissions compared to the cohort receiving standard education efforts. ED visits were not significantly different amongst cohorts. This practice improvement project demonstrates successful translation of research into practice. The use of focused education and the RN-RHDS tool is recommended for nursing to improve patient readiness for discharge and patient outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Transitioning patients from the hospital to home after a total hip or knee arthroplasty is challenging. Severe pain, comorbidities and complex medication regimes have the potential to delay readiness for discharge, increase length of stay (LOS), and cause readmissions.
OBJECTIVE OBJECTIVE
The goal of this practice improvement project was to improve patient readiness for discharge after total joint arthroplasty to reduce LOS, prevent emergency department (ED) visits, and prevent hospital readmissions.
METHODS METHODS
This quality improvement project was guided by the Iowa Model and implemented a prepost program implementation evaluation design. Nurses incorporated the Registered Nurse Assessment of Readiness for Hospital Discharge Scale (RN-RHDS) to guide and evaluate discharge education efforts.
RESULTS RESULTS
The focused education cohort demonstrated significantly decreased LOS and decreased readmissions compared to the cohort receiving standard education efforts. ED visits were not significantly different amongst cohorts.
CONCLUSION CONCLUSIONS
This practice improvement project demonstrates successful translation of research into practice.
IMPLICATIONS FOR NURSING CONCLUSIONS
The use of focused education and the RN-RHDS tool is recommended for nursing to improve patient readiness for discharge and patient outcomes.

Identifiants

pubmed: 34716277
pii: JDNP-D-20-00060
doi: 10.1891/JDNP-D-20-00060
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Copyright 2021 Springer Publishing Company, LLC.

Auteurs

Emma Betty Kamau (EB)

University of Miami School of Nursing and Health Studies, Coral Gables, Florida ekamau@umiami.edu.

Cynthia Foronda (C)

University of Miami School of Nursing and Health Studies, Coral Gables, Florida.

Victor Hugo Hernandez (VH)

University of Miami Miller School of Medicine, Miami, Florida.

Brian Anthony Walters (BA)

University of Miami Miller School of Medicine, Miami, Florida.

Classifications MeSH