Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

5-5-2018

Degree Program

Doctor of Nursing Practice

Degree Track

Post Master's DNP Completion

Year Degree Awarded

2018

Month Degree Awarded

May

Keywords

CHF exacerbation, professional interpreters, disease management, patient-centered education, increased self-care management at discharge, readmission.

Advisor

Dr. Jean DeMartinis

DNP Project Chair

Dr. Jean DeMartinis

Abstract

Abstract

Background and Review of Literature: The high rate of hospital readmissions has become a national issue after the Affordable Care Act began and was found to be related to lack of proper education and communication during discharge, coupled with medication nonadherence. Purposes/Goal: The overarching goal of this DNP project was to improve lifestyle management of Spanish-speaking congestive heart failure (CHF) patients and to reduce their 30-day readmission rate. The intent of the project was to improve patients’ understanding of CHF exacerbation, medications, and discharge instructions geared to increase home self-management and reduce recidivism. The specific aims were (a) to use a professional Spanish interpreter (PSI) during discharge of Spanish-speaking patients, (b) to provide education via the “Teach-Back” method, assessing patients’ understanding of discharge instructions before and after using PSI and (c) to follow up for reinforcement of the discharge education.

Methods: Using the PSI, the simple evidence-based DHFKS as a Teach-Back method was used to help patients identify some key aspects of behavior and lifestyle modification.

Implementation/Procedure: This DNP project was conducted at an acute care facility in the city of Elizabeth, New Jersey. The DHFKS as an educational tool to guide the Teach-Back on admission and during discharge using a PSI. Results: The Wilcoxon signed-rank test showed that using a PSI to improve patients’ understanding of discharge instructions did significantly lower the number of hospital admissions of Spanish-speaking CHF patients (Z = -3.879, p < 0.001).

Interpretation/Discussion: Two months after the project intervention, the CHF patients who speak Spanish only who received help from a PSI at discharge had significant reduction of the frequency of their readmission compared with their previous admissions.

Implications/Conclusion: This QI project will encourage stakeholders to provide PSIs to all Spanish patients with limited English during admission and discharge. PSI use improves self-care management of patients with CHF and reduce readmission.

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