Date of Degree
Fall 2024
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
Abstract
Problem: The practice site, a nationally certified stroke care hospital, faced challenges with 30-day post-stroke readmission rates of 8.7%, below the national average of 12.44%. This quality improvement initiative aimed to reduce avoidable readmissions to below 4.7% by implementing a structured education process using a post-stroke checklist for all stroke admissions.
Aim of the Project: The primary goal was to ensure that all stroke patients received consistent discharge education. This was achieved by introducing the American Heart/Stroke Association Post-Stroke Discharge Checklist, aligning with best practices to standardize patient education.
Review of Evidence: Evidence shows inconsistencies in the discharge process, particularly with novice staff, often lead to inadequate patient education on stroke risks, prevention, and follow-up care. Poor discharge planning contributes to unplanned readmissions, functional decline, and financial strain on both healthcare systems and patients.
Project Design: This quality improvement project, conducted on the Integrated Stroke Unit, involved providing a post-stroke discharge checklist to all stroke patients. Patients and caregivers were encouraged to ask questions, take notes, and complete the checklist before discharge with staff assistance. The OhioHealth Change Management Model guided systematic improvements in stroke education, with two PDSA cycles testing changes during the project.
Intervention: Upon admission, patients and caregivers received the post-stroke discharge checklist and an explanation of its purpose. Staff provided education throughout the patient's stay, ensuring understanding and documentation of checklist completion at discharge. Weekly audits were conducted and reported during staff huddles.
Significant Findings/Outcomes: The project successfully reduced 30-day post-stroke readmission rates from 8.7% to 3.9%, surpassing the target of 4.7%. This underscores the importance of patient/caregiver collaboration in improving education and reducing avoidable readmissions.
Implications for Nursing: Improved patient education enhances nursing practice by reducing unplanned readmissions, which place financial and operational burdens on patients and healthcare staff. This aligns with the IOM’s six domains of healthcare quality: providing safe, effective, patient-centered, equitable, efficient, and timely care. In eight weeks, the unit successfully reduced post-stroke readmissions through adequate education.
Recommended Citation
Robinson, Monika, "Reducing 30-day Post-Stroke Readmissions with a Discharge Checklist Tool" (2024). Doctor of Nursing Practice (DNP) Scholarly Project. 13.
https://fuse.franklin.edu/dnp-project/13
Rights
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