An educational initiative to prevent unnecessary hospitalization for hospice patients
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Abstract
Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose was to develop an educational curriculum to educate the staff on the care paths with a pretest/posttest to assess knowledge gained from the education. Rosswurm and Larrabee’s conceptual model was used to frame the project. Three content experts evaluated the curriculum plan using a 4 item dichotomous rating of 1 (not met) and 2 (met). An average score of 2 revealed that the curriculum content met the course objectives. Content experts validated each of the 16 pretest/posttest items using a Likert scale ranging from 1 (not relevant) to 4 (highly relevant). The content validation index score was .94, indicating that the pretest/posttest reflected the course objectives and content. Recommendations were made for structuring the pretest/posttest. The project promotes social change by assessing, intervening, and treating patients in the outpatient hospice setting to prevent avoidable hospitalizations, thus promoting patient well-being and fiscal responsibility of healthcare dollars.
Description
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 10254449; ProQuest document ID: 1870623601. The author still retains copyright.
Repository Posting Date
2020-12-11T16:38:52Z
Notes
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type Information
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Category Information
Evidence Level | Clinical Practice Guideline(s) |
Research Approach | Mixed/Multi Method Research |
Keywords | Hospice Nurses; Patient Care Improvement; End of Life Care |
CINAHL Subject(s) | Hospice Patients; Hospitalization; Medicare; Course Evaluation; Hospitalization--Economics; Medicare--Economics; Curriculum Development |
Degree Information
Grantor | Walden University |
Advisor | Moon, Joan |
Level | DNP |
Year | 2016 |
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