Phase V .Apa Seven

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Phase 2- Design

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Phase 2- Design

Brief literature review

For too many patients, the healthcare door is one that they consider to be a revolving one.

Approximately 20% regarding the Medicare patients usually leave the healthcare centers only for

them to be readmitted within a months time. The failure to come up with the standard discharge

processes, efficient preparation of patients and the family caregivers for discharge, effective

education of patients in regard to medications and communicate appropriately with the identified

post discharge providers is all associated with causing readmissions (Chen et al., 2021).

Through effective coordination as well as communication, planning and education, nurses

as well as the nurse case administrators can play a key role in the reduction of readmissions.

Beginning at the admission phase, there is the possibility of the mitigation of readmission risks at

the various points in the cases of pre discharge as well as post discharge periods via effective

determination of the readiness for discharge by the patients as well as the compilation of an

extensive as well as accurate form of discharge summary, coordination of care with numerous

settings as well as providers and much more.

Nursing Interventions during the Process of Discharge

Most of the studies usually connect readmissions with the lack of effective and fast follow

up by the identified primary care type of providers as well as other kinds of healthcare experts.

Patients ought to possess an effective follow up appointment that is scheduled within 48 hours to

am average of7 days after they have been discharged. There are numerous strategies in this case

which can be used which are the development of scheduling kinds of agreements with the local

clinics like the system affiliated ambulatory care kinds of clinics. There is also the creation of

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processes for the assignment of patients to an identified PCP if they lack one. It is also vital to

facilitate effective education of patients as well as the home caregivers on the significance

associated with timely as well as effective follow up (Lee et al., 2021).

Post discharge nursing related interventions

The identified period immediately after any kind of patient discharge is one that is

considered to be a vulnerable time for the patients one whereby rapid alterations can take place.

Having a follow up with the identified patients as well as the home types of caregivers soon after

the identified discharge can minimize confusion as well as effectively reinforce the follow up kind

of plans. The most common topics to be discussed in the first post discharge phone call entails the

medications as well as pending services and more (Wong et al., 2021).

Discharge to a setting other than home

When a given patient is considered to be discharged to a setting that is other than the home,

nurses as well as the NCMs can effectively play a key role in the prevention of the transfer back to

the identified hospital. Interventions to minimize the acute transfers is considered to be a quality

improvement kind of program which is associated with the provision of an evidence based kind of

guide and the necessary tools formulated to minimize transfers from the identified long term care

as well as assisted living settings to the acute care kinds of hospitals. This is essential in enhancing

patient safety as well as satisfaction and in the reduction of readmissions via early identification as

well as evaluation of the key changes in the condition of the patients (Maki et al., 2021).

Halting the readmission cycle

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Hospital readmissions are considered to be expensive to the patients as well as the

healthcare facilities. Nurses as well as the NCMs are considered to be natural communicators as

well as educators which puts them in a perfect position to assist in the prevention of readmissions

at various points. Being familiar with as well as utilizing easily accessible, evidence based tools

can assist nurses as well as the NCMs in the management of patient transitions optimally and even

consistently (McHugh et al., 2021).

Methodology and design of the study

Intervention Mapping is considered as being a systematic as well as an iterative six phases

process which assists in the development of an intervention kind of system on the basis of the

theoretical as well as empirical and even practical information. IM was initially utilized

appropriately in the identified health promotion kind of domain to come up with programs for the

issue of smoking cessation as well as stroke prevention, HIV prevention and leg ulcer

management. There is the use of PRECEDE PROCEED MODEL to effectively analyze as well as

illustrate the identified scale along with causes and even impacts regarding Health issues and in the

identification of the target population.

Procedure & participants

A literature kind of search on the identified frequency as well as impacts regarding

ineffective hospital discharge issue will be performed. There will be the performance of a large

kind of qualitative study on the identified patient handovers between the identified acute care

healthcare centers as well as the primary care in the US. This will be vital in the identification of

the behavioral as well as the environmental Level determinants impacting ineffective healthcare

centers discharge. The study to be performed will adhere to RATS which stands for relevance as

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well as Appropriateness, Transparency and Soundness guidelines for the qualitative types of

studies. Data analysis as well as analysis will comprise of multi-method kind of qualitative study

inclusive of the individual as well as the focus group kinds of interviews, process maps and the

artefacts Analysis.

Intervention Results, performance Goals & change Goals

There was also the identification of the desired results regarding the intervention as well as

formulated particular performance objectives for the identified target population like writing of a

complete as well as accurate and even timely kind of discharge letter by the identified hospital

physician. This led to a step by step kind of checklist regarding what needs to be achieved so as to

attain the most effective results. It is vital to facilitate the identification of the necessary steps

needed to be tweaked so as to impact the performance goals and eventually the intervention results.

There was the identification of the most vital kind of determinant such as the lack of knowledge as

well as comprehensive understanding between the healthcare center as well as the primary care

types of providers which are required to be altered as well as combined these with the performance

goals to design the alteration goals.

Sampling methodology

Stratified sampling

In this method, the identified population is usually first divided into key subgroups or even

strata who are all involved in sharing of the same features. It is usually utilized when the

researchers may reasonably anticipate the identified measurements regarding the interest to vary

between the distinct kinds of subgroups and there is the need to make sure there is representation

from all the identified subgroups. In this kind of sampling Methodology, the identified study

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sample is usually obtained via taking equal and fair sample sizes from each of the given stratum. In

the stratified kind of sampling, it is also considered to be vital to select non-equal sample sizes

from each of the identified stratum.

This is vital in ensuring there is the achievement of a highly realistic as well as accurate

estimation regarding the health outcomes regarding nurses across the region while for simple

random kind of sampling, there would be the over representation of the nurses from the identified

healthcare centers. It is vital to understand that the fact that the given sample was effectively

stratified ought to be put into consideration at the identified analysis stage. This kind of sampling

Methodology helps in the improvement of accuracy as well as representativeness regarding the

outcomes by the reduction of the sampling bias (Valliant et al., 2018).

Necessary tools

The necessary tools are audio recorders as well as form plus online kind of questionnaire.

The audio recorder is utilized for the key aim of recording sound on the discs as well as tapes and

films. The audio kind of information is considered to be highly suitable since it can effectively

meet the key needs regarding a wide range of individuals along with offering alternatives to the

printing of data gathering tools (Narasimharao et al., 2017). Form plus is associated with letting an

individual to effectively create strong forms to assist in the collection of the information which is

needed. It is vital in the creation of online forms for getting actionable trends as well as measurable

kinds of responses.

Any algorithms or flow maps created

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References

Chen, J., Wijesundara, J. G., Patterson, A., Cutrona, S. L., Aiello, S., McManus, D. D., ... &

Houston, T. K. (2021). Facilitators and barriers to post-discharge pain assessment and

triage: a qualitative study of nurses’ and patients’ perspectives. BMC Health Services

Research, 21(1), 1-15.

Maki, S., Nagai, K., Ando, S., & Tamakoshi, K. (2021). Structure and predictors of in-hospital

nursing care leading to reduction in early readmission among patients with schizophrenia in

Japan: A cross-sectional study. PLoS one, 16(4), e0250771.

McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021).

Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality,

readmissions, and length of stay: a prospective study in a panel of hospitals. The

Lancet, 397(10288), 1905-1913.

Oh, E. G., Lee, H. J., Yang, Y. L., & Kim, Y. M. (2021). Effectiveness of discharge education with

the teach-back method on 30-day readmission: a systematic review. Journal of patient

safety, 17(4), 305-310.

Valliant, R., Dever, J. A., & Kreuter, F. (2018). Practical tools for designing and weighting survey

samples.

Wong, C. H., Cheung, W. K., Zhong, C. C., Yeoh, E. K., Hung, C. T., Yip, B. H., ... & Chung, V.

C. (2021). Effectiveness of nurse-led peri-discharge interventions for reducing 30-day

hospital readmissions: Network meta-analysis. International Journal of Nursing Studies,

103904.

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