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Effect of a Nurse

Practitioner Directed
Discharge Intervention on
30 day Hospital
Readmission
Leonora Abiera DNP student,
ANP-C
Stony Brook University
School of Nursing

Background
Readmissions are costly and are
associated with increased mortality
Coronary artery bypass graft surgery
(CABG) readmissions remain high
Readmissions are attributed to poor
discharge planning

Purpose

To examine the effect of a nurse


practitioner (NP) discharge
intervention on the 30 day
readmission rate of elderly patients
after CABG surgery.

Theoretical Framework
Diffusion of Innovation
Diffusion
Communicate
innovation

Innovation
NP
discharge
education

Disseminate
Actions
Awareness
Adopt
Implement
Institutionalize

Cardiac
Surgery
Readmissio
n
prevention

Sample
Inclusion Criteria

Age 65 years and older


Communicates in English language
First and elective CABG surgery
Must have a working telephone

Sample
Exclusion Criteria
Prior open heart surgery
Unable to communicate in
English
Cognitive impairment or mental
illness
significant hearing problems

Methods
Quasi Experimental Design-pilot study
Convenience sampling
Standard group routine hospital
discharge
Experimental group routine hospital
discharge plus NP education

Methods

Measurements
Demographic Questionnaire
Patient Learning Need Scale (PLNS)
-self report measure of important
topics to learn
Readiness to Hospital Discharge Scale
(RHDS)
-Self report measure of readiness to
hospital discharge

Data analysis
Statistical Package for Social Sciences
statistic software (SPSS)
Descriptive statistics for sample
characteristics
Chi square, Independent t-test,
Pearson correlation to explore
relationships of variables

Results
Demographic N=68

Age 65 to 88 M=72
Male 54 (79%)
Married 51 (75%)
Caucasian 48 (71%)
College education 37(54%)
Live w others 53 (78%)
Unemployed 40 (49%)
Presence of 3 to 4 comorbid 42 (62%)

Readmission in 30
days

Result

Readmission rate in 30 days did not


differ between the standard and
intervention group
There was a significant relationship
between readiness to hospital
discharge and patients learning
needs

Implication to nursing

Readmission is viewed as a poor


outcome of health care.
NPs are in a position to optimize
inpatient discharge teaching and help
patients deal with the stress of
surgery
Assessment of learning needs and
readiness to hospital discharge is
essential for a successful discharge.