Date of Completion
Summer 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
Abstract
Problem:
The problem identified at the project site is that care transitions for patients with COPD lack standardized discharge processes, leading to inconsistent education, limited follow-up, and poor coordination of care.
Aim of the Project:
The primary aim was to improve patient outcomes by reducing the 19.6% 30-day readmissions among older adults diagnosed with COPD at the selected project site by implementing a standardized discharge intervention over 12 weeks, measuring progress, and ensuring appropriate workflow. The initiative of this project sought to foster a sense of proper continuity of care through timely follow-up, interprofessional communication among patients and providers, and applying community resources where applicable.
Review of the Evidence:
The use of comprehensive discharge education utilizing teach back methods, evidence-based strategies, timely follow-up, post-discharge phone calls and having consistent improvements in patient engagements, continuity of care, and readmission outcomes supported the development and implementation of the standardized COPD discharge bundle.
Project Design:
The DNP quality improvement project incorporated the Plan-Do-Study-Act (PDSA) framework and Ohio health change management model to support the implementation of evidence-based interventions aimed at reducing 30-day hospital readmissions among adult patients with chronic conditions through improved discharge education and enhanced electronic health record documentation.
Intervention:
Interventions for this project included maintaining standardized teach-back discharge education, staff compliance to EHR discharge documentation, proper medication reconciliation, staff follow up telephone calls within 48 to 72 hours of discharge, timely scheduling patients’ follow-up appointments within seven days, incorporating social determinants of health screening, continuing staff education, and keeping a line of communication for staff feedback.
Significant Findings/Outcomes
The project successfully achieved its primary aim through the reduction of 30 days COPD readmission rate from 19.6% to 12.6%. This greatly surpassed the organizational goal of reducing readmissions below 15%. Overall, the standardized COPD discharge bundle was essential in improving care transition and reducing preventable hospital readmissions.
Implications for Nursing
Standard discharge education reduced COPD readmissions while improving continuity of care, maintaining interdisciplinary collaboration, and incorporating evidence-based nursing practice. The project aimed to improve patient outcomes, healthcare quality and successful organizational performance through the integration of structured discharge protocols in primary care settings.
Recommended Citation
Rubio, Florwisse, "A Quality Improvement Approach to Reducing Chronic Obstructive Pulmonary Disease Readmissions" (2026). Doctor of Nursing Practice (DNP) Scholarly Project. 72.
https://fuse.franklin.edu/dnp-project/72
Rights
Copyright, all rights reserved
Included in
Health and Medical Administration Commons, Health Information Technology Commons, Interprofessional Education Commons, Medical Sciences Commons
