Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
11-9-2018
Degree Program
Doctor of Nursing Practice
Degree Track
Post Master's DNP Completion
Year Degree Awarded
2018
Month Degree Awarded
May
Keywords
readmission, transitional care, cardiac surgery, discharge planning, health literacy, and teach-back
Advisor
Dr. Terry Black, DNP, MBA, CRRN, FAHA, FAAN
DNP Project Chair
Dr. Terry Black, DNP, MBA, CRRN, FAHA, FAAN
DNP Project Member Name
Dr. DeMartinis, PhD, FNP-C
DNP Project Outside Member Name
Dr. C. Mack, III
Abstract
Abstract
Background: Readmissions after cardiac surgery are often preventable, costly, and potentially life-threatening events. Hospital readmissions may be influenced by low health literacy and ineffective transitional care. The Centers for Medicare and Medicaid Services have included reducing hospital-bundled payment for frequent occurrence of readmissions and episodic care after coronary artery bypass grafting in 2017. Purpose: This Quality Improvement project explored the impact of applying the STAAR initiative to reduce unplanned readmissions, and to provide safe transitional care in post-cardiac surgery patients. Design/Methods: This was a QI project design with educational and observational methods. The DNP student used the transitional-care toolkit by applying the process of the Plan-Do-Check-Act cycle. Implementation Plan/Procedure: Application of the STAAR initiative as a transitional-care program provided a patient-centered approach. Participants were recruited from the patients' cardiac surgery log who met the inclusion criteria from October 2, 2017 to January 2, 2018 at a tertiary facility in New York City (NYC). Quantitative and qualitative data analyses were compared and analyzed as to whether the STAAR interventions have an impact in providing safe transition and reducing unplanned readmission. Results/Interpretations: After 3 months of implementing the STAAR initiative, the readmission rates were lowered from 16.3% to 5%. A z-test, one-tailed yielded at p < 0.05 value, which was statistically significant. Implications/Conclusions: The Advanced Practice Nurse was successful in supporting the transitional-care program. Education was the key of the transitional care. It improved heath literacy, increased medication adherence, and it lowered unplanned readmission.
Keywords: readmission, transitional care, cardiac surgery, discharge planning, teach-back, and health literacy.
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