Details

Autor(en) / Beteiligte

• Bernard, Jennifer

Titel

Impact of a RED Toolkit-Based Discharge Process on Patients with Hip Fracture: a Doctor of Nursing Practice Project

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2020

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Twenty percent of all Medicare patients discharged from the hospital are readmitted within 30 days. Patients who are at high risk for readmission are often cared for in Inpatient Rehabilitation Facilities (IRFs) with lower motor function scores, including patients with hip fracture. The goal of this DNP project was to lower 30-day healthcare reutilization for patients age ≥ 50 with hip fracture by using an evidence-based discharge process method, the RED Toolkit. Healthcare reutilization is a term encompassing patient hospital readmission, emergency department visits, and urgent care visits. The expected outcomes of this project were to lower healthcare reutilization, increase patient knowledge of patient self-management, and increase patient satisfaction in patients with hip fracture at an IRF.Inpatient and outpatient discharge process revisions were implemented at an IRF based on RED Toolkit recommendations. Inpatient revisions included patient barrier identification with associated documentation changes to the IRF interdisciplinary team form. Outpatient revisions consisted of an After-Hospital Care Plan (AHCP) and two post-discharge Telephone Follow-Up (TFU) calls provided to patients. Outcomes were measured for a three-month period and compared to pre-intervention data.Healthcare reutilization and thirty-day hospital readmission for this project was measured at 8.5% and 5.7%, respectively. A decrease in healthcare reutilization of at least 1.6% was observed for the IRF in comparison to 2015-2017 data. No statistical association between healthcare reutilization and patient motor score was observed. Most participants scored at the high level (88.6%) of ‘patient knowledge of self-management’ post intervention. Out of participants who did not attend their first Primary Care Provider (PCP) appointment, 33.3% experienced healthcare reutilization. This result emphasized the importance of seeing one’s PCP post-discharge. Patient satisfaction increased by 5% and 6.73%, measured by HCAHP scores for nursing care and physician care, respectively. Implementation of a RED Toolkit-based discharge process at an IRF positively impacted all three study outcomes and associated healthcare costs in lowering preventable readmissions.