Date of Award

Spring 5-2-2015

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Advisor

Barbara H. Schaffner, PhD, CNP

First Committee Member

Barbara H. Schaffner PhD, CNP

Second Committee Member

Ruth Chavez DNP, RN

Third Committee Member

Deborah Gonot PhD, RN

Keywords

Discharge planning, Hospital, Nursing, Adult learning, Discharge

Subject Categories

Educational Methods | Medical Education | Medicine and Health Sciences | Nursing | Teacher Education and Professional Development

Abstract

Abstract

Problem Statement: The frequency and severity of hospital post-discharge events has become a national problem. The increase in readmission rates post-discharge has a negative impact on the patients overall morbidity and increases healthcare costs (Jack, 2012). Non-comprehensive discharge planning contributes to post-discharge events such as less than 30-day readmissions (Jack, 2012). Best practices for discharge planning should be utilized.

Purpose: The purpose of this project was to evaluate the impact of Project Re-engineering Discharge (RED) education to increase nurses' knowledge and use of best practices on discharge planning. An adapted Project RED educational intervention, using Knowles' adult learning theory, was provided to the nursing staff to increase the nurses’ knowledge and retention of current discharge best practices and to increase the nurses' use of discharge best practices.

Methods: A quantitative study using pretest and posttest design to assess and focus on the nurses' knowledge and understanding of discharge best practices was used. An educational intervention was provided to the nurses, created from the Project RED toolkit. A post-test was re-administered 30 days post intervention to assess retention of knowledge and use of discharge best practices.

Analysis/Results: Paired t-tests were used to compare overall pre and post-test results related to knowledge gained from the educational intervention. The first paired t test (Pre-M 24, SD= 3.54/Post-M= 26, SD=2.53) looked at pre and post intervention scores per test question. A second paired t-test (Pre-M= 17.07, SD= 1.43/post-M=18.43, SD= 1.43) looked at pre and post intervention test scores per participant. The results indicated that per participant (t= 7.44, p= 0.001) as well as per question (t= 3.76, p = 0.001) a statistically significant improvement in knowledge was found between the pre and post intervention scores. Self-reported use of best practices revealed a statistically significant (p < .05) increase in reported use of best practices in discharge practice.

Conclusions: The evidence from this project supports the hypothesis that the educational offering did in fact have a significant statistical effect on the participant’s knowledge, and retention of current discharge best practices when using a pre-/posttest design. The data also indicated that this statistically significant knowledge gain was accompanied by a statistically significant increase in frequency of use of best discharge practices by the participants.

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