Evidenced Based- Analyzing articles

Hospital Readmissions

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May 17, 2020

Clinical Question

In Medicare beneficiary’s population, does bed-side teaching from nurses reduce hospital readmission compared to the implementation of Hospital Readmissions Reduction Program (HRRP) within thirty days after discharge? The research aims to describe the evidence-based interventions that could be beneficial in preventing hospital readmission.

Level of Evidence

A quantitative study contributes to the substantial evidence for nursing practice and allows the analyzer to see what the effectiveness of the interventions were (Houser, 2018). Therefore, the study will help nurses to understand the effectiveness of the intervention in preventing unnecessary hospital readmissions. The type of clinical question is a preventative question. Quantitative studies assist the nurse to design interventions that prevent obstacles and address the issues to assist patient to maintain and attain good health (Houser, 2018).”

Search Strategy

There are critical points in the topic chosen to find the search terms. For example, the category the group was assigned was Avoiding Hospital Readmissions. The two terms that searched in compiling the resources were hospital readmissions and preventions. Once the key-points are identified, the websites are then searched. The use of Chamberlain Library was utilized, which has Ebsco and ProQuest. These databases must then be refined into what type of articles used. The ones that were picked were from a scholarly resource that was primary use. The articles chosen contained evidence-based information. The topic relates to healthcare, so Ebsco and ProQuest were used. These databases include appropriate and evidence-based information to avoid hospital readmissions.

Furthermore, the articles found consisted of statistical data that include quantitative studies and analysis of the objective. It is then refined by specifying the population when working with Medicare beneficiaries (Wadhera et al., 2018). It is refined in terms of the publication company, the population group to be studied, the ages, date that is was released, and the level of evidence from a retrospective cohort study. It then goes into answering the PICOT question. Explicitly, it specifies the population that is utilized, the intervention which is Health Readmissions Reduction Program (HRRP) making changes, comparison- the absence of mortality rate, outcome, and the periods. In this study, it included approximately 8 million Medicare beneficiary fee-for-service hospitalizations from 2005 to 2015; the implementation and execution of the HRRP was associated with a significant increase in trends in 30-day post-discharge mortality among beneficiaries hospitalized for heart failure and pneumonia, but NOT for acute myocardial infarction (Wadhera et al., 2018). These numbers seem staggering because it suggests that the mortality rates done in this group of people are significantly increased when they are discharged or released from the hospital too soon. Thus, it leads to the conclusion, among Medicare beneficiaries. The survey pattern and the need for a significant association of the HRRP effort with a rate within 45 days of hospital admission suggest that more research is required to see whether the increase in 30-day post-discharge rate is the result of the HRRP (Wadhera, et al., 2018).

The secondary resource comes from an evidence-based sheet. The hospital readmission rates the high standard for acute-care hospitals. In 2013, the Center for Medicare and Medicaid assistance (CMS) began penalizing hospitals for extra readmission charges, specifically those readmissions linked to heart failure, acute myocardial infarction, and pneumonia. Approximately 33 percent of hospitals account that their contract with CMS reduces compensation for patients who are readmitted within 30 days. That is why it is essential as nurses to convey any concerns you may have to prevent the early termination of the patient (Mannella et al., 2018). It ends the data by concluding that nurses should develop an individualized discharge plan for your patients. They should provide high-quality healthcare to your patients to promote positive patient outcomes and reduce the risk for hospital readmissions (Mennella et al., 2018).

Conclusion

Overall, research is substantial and essential when education is to pursue and especially when it needs to be implemented to the patient before discharging them home too quickly. Nurses should have a level of quality and patient-centered care to practice the effectiveness of interventions and then apply them to their care for the patient (Houser, 2018). Currently, the Medicare beneficiaries suffer from comorbidities that lead to mortality at staggering numbers. From being discharged from the hospital two soon, whether several days or several weeks, these mortalities can be prevented. Education is essential when discharging patients. Evidence-based practice interventions must be implemented by the nurse to decrease these numbers in the aging population. We provide the care and level of need for everyone. Being knowledgeable about hospital readmissions gives nurses a better understanding of the type of care that is needed and individualized for any comorbidity, whether they have Medicare or not.

References

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Burlington, MA: Jones & Bartlett Learning

Mennella, H. D. A.-B. (2018). Hospital Readmissions: United States Centers for Medicare and Medicaid Services (CMS). CINAHL Nursing Guide.   https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T904065&site=eds-live&scope=site

Wadhera, R. K., Maddox, K. E. J., Wasfy, J. H., Haneuse, S., Shen, C., & Yeh, R. W. (2018). Association of the Hospital Readmissions Reduction Program with mortality among Medicare beneficiaries hospitalized for heart failure, acute myocardial infarction, and pneumonia. Jama, 320(24), 2542-2552.