Week 4 Literature review
2
Background and Introduction
Diana Aranda
Denver College of Nursing
NUR695
Instructor’s Name: Sharon Bator
October 22, 2023
Background and Introduction
Nursing education and healthcare practice issues prompted the research paper topic "Hospital readmission within 60 days after discharge to homecare". Hospital readmissions are a major issue for older patients with chronic conditions transitioning to home care, affecting patient well-being and healthcare costs. This topic sheds light on hospital readmissions within 60 days of homecare discharge.
Hospital readmissions are an issue of paramount importance in global healthcare systems. Healthcare quality and costs are affected by them. After discharge, patients who return to the hospital raise concerns about their health, initial care, and home care. This is particularly important for older, chronically ill persons with complex medical demands. According to Chen et al. (2020), hospital readmissions in this group are difficult and require further study.
The characteristics of this study's organizations are diverse and range from hospitals to home care agencies. Medical staff, nurses, home health aides, and family caregivers affect care quality and readmission during the hospital-to-homecare transition. The hospital-to-homecare transfer necessitates understanding these groups' dynamics. Elderly chronic illness patients' healthcare needs, functional limitations, and social support networks are also examined. Healthcare systems are complex, and these variables make the topic tough, requiring a thorough analysis.
Healthcare and socioeconomic issues arise from older chronic illness hospital readmissions in a growing aging society. Hospitalizations must be considered for cost and health risks. Therefore, this research issue is important and will provide essential insights to guide nursing education and practice. This research addresses literature gaps and investigates the causes of hospital readmissions for elderly patients transitioning to home care to optimize nursing interventions to reduce readmission rates and improve patient outcomes and healthcare system efficiency. An in-depth investigation of this problem, taking into account the organizations involved, is necessary to design evidence-based methods to improve home care for older people with chronic illnesses.
Local Problem - Nature and Severity of the Problem
The local problem of hospital readmission within 60 days after discharge to home care is a concern in our community and healthcare system. This issue hinders citizens' health and costs local hospitals a significant financial burden. Understanding this problem's scope is essential to finding solutions that improve patient care, lower healthcare costs, and optimize nursing practice.
The problem's nature can be described as a loop of patients, especially older adults with chronic illnesses, being discharged from the hospital to get home care only to return soon after. This cycle shows a gap in the continuum of treatment, including the transition from hospital to home care. Readmissions often result from difficulties, medication errors, or inadequate post-discharge support. One of the critical aspects of the problem's nature is its impact on the elderly population. Older adults have more chronic illnesses that require extensive care, and their physical and functional limitations may make them more susceptible to difficulties or setbacks following hospital discharge (Abdi et al., 2019). Our community's growing older population, a trend seen worldwide due to demographic transitions, worsens the problem. This demographic transition directly affects an increasing section of our population, making hospital readmissions among this group more critical.
The financial costs to patients and healthcare organizations further underline the problem's severity. According to Upadhyay et al. (2019), hospital readmissions cost patients, families, healthcare facilities, and the healthcare system. If a patient gets readmitted quickly, it shows that the initial care was ineffective and their health deteriorated. Readmissions increase healthcare expenses, burdening people financially and raising insurance premiums, reducing community access to care. Moreover, the severity of the problem is closely tied to patient satisfaction and overall healthcare outcomes. Readmissions can cause patient dissatisfaction as individuals often equate returning to the hospital with suboptimal care. This affects patients' experiences and healthcare system trust. The patient may be readmitted several times and develop hospital-acquired infections and other health issues.
A local solution to improve the transition from hospital to home care, especially for older, chronically sick patients, is needed due to the problem's nature and severity. This holistic solution should address drug management, patient education, caregiver assistance, and healthcare coordination. To ease the transition and reduce readmission rates, we must analyze our local healthcare organizations' unique qualities and how to maximize them.
Generally, the local problem of hospital readmission within 60 days of homecare discharge is defined by a recurring cycle of patients returning. The expanding older population in our community, the financial consequences for individuals and healthcare institutions, and the influence on patient satisfaction and healthcare results worsen this situation. This problem must be addressed locally to improve patient care and healthcare quality and reduce the financial load on our healthcare system. A comprehensive approach that addresses our community and healthcare organizations' specific qualities is needed to optimize nursing interventions and improve resident well-being.
Intended Improvement
The recommended homecare nursing interventions to reduce hospital readmission rates in older, chronically ill patients are designed to improve care procedures and patient outcomes. These multiple changes are essential for reducing hospital readmissions within 60 days of discharge. The following are critical areas for improvement.
Improved Patient Education and Empowerment
Nursing interventions aim to enable elderly chronic illness patients to maintain their health at home. This involves extensive education to help people understand their diseases, medication adherence, warning indicators, and proper care. Customized education and resources will help people manage their health independently, boosting self-efficacy and confidence in managing chronic conditions (Harvie, 2021). This, in turn, should lead to better self-care, fewer problems, and fewer hospital readmissions.
Medication Management and Adherence
Optimizing older medication management is crucial to the proposed strategies. Medication adherence rates should increase by simplifying prescription regimens, offering reminders, and ensuring patients understand the purpose and correct administration of their medications (Aremu et al., 2022). Reduced exacerbations and hospital readmissions can result from better medication adherence in chronic illness patients.
Care Coordination and Monitoring
Another critical dimension of the proposed interventions is the enhancement of care coordination and monitoring. To provide a coordinated and complete patient care strategy, nurses, physicians, and home health aides must streamline communication.Vital signs, symptom changes, and treatment plan compliance must be monitored often to identify concerns that could lead to hospital readmission (Coffey et al., 2022). Healthcare practitioners can prevent readmissions by strengthening care coordination and continuous monitoring.
Improved Health Literacy
The nursing interventions are designed to enhance health literacy among elderly patients with chronic illnesses. This development in health literacy should help people comprehend their illnesses, resources, and the significance of appropriate medical intervention. Patients who are better aware and competent in managing their health are less likely to delay seeking care, which can reduce problems and hospital readmission.
These intended improvements in care processes and patient outcomes should significantly improve homecare for older, chronically ill patients. The proposed interventions will likely reduce hospital readmissions within 60 days of discharge by addressing the factors that cause them, saving healthcare systems money, improving patient satisfaction, and, most importantly, improving health outcomes for this vulnerable demographic. These advances support healthcare goals like improving patient well-being, optimizing resources, and providing patient-centred home care.
Study Questions
The study intervention's main improvement question is: "Can nursing interventions to improve patient education, medication management, care coordination, and health literacy significantly reduce hospital readmission rates within 60 days for elderly patients with chronic illnesses in-home care?"
References
Abdi, S., Spann, A., Borilovic, J., de Witte, L., & Hawley, M. (2019). Understanding the Care and Support Needs of Older people: a Scoping Review and Categorisation Using the WHO International Classification of functioning, Disability and Health Framework (ICF). BMC Geriatrics, 19(1). https://doi.org/10.1186/s12877-019-1189-9
Aremu, T. O., Oluwole, O. E., Adeyinka, K. O., & Schommer, J. C. (2022). Medication Adherence and Compliance: Recipe for Improving Patient Outcomes. Pharmacy, 10(5), 106. https://doi.org/10.3390/pharmacy10050106
Chen, H., Cates, T., Taylor, M., & Cates, C. (2020). Improving the US hospital reimbursement: how patient satisfaction in HCAHPS reflects lower readmission. International Journal of Health Care Quality Assurance, ahead-of-print(ahead-of-print). https://doi.org/10.1108/ijhcqa-03-2019-0066
Coffey, J. D., Christopherson, L. A., Williams, R. D., Gathje, S. R., Bell, S. J., Pahl, D. F., Manka, L., Blegen, R. N., Maniaci, M. J., Ommen, S. R., & Haddad, T. C. (2022). Development and implementation of a nurse-based remote patient monitoring program for ambulatory disease management. Frontiers in Digital Health, 4. https://doi.org/10.3389/fdgth.2022.1052408
Harvie, D. S. (2021). Immersive Education for Chronic Condition Self-Management. Frontiers in Virtual Reality, 2. https://doi.org/10.3389/frvir.2021.657761
Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56(56), 004695801986038. https://doi.org/10.1177/0046958019860386