NR 451 Week 3: Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet (graded)

The Hospital discharge planning for reduction of readmission of patients

The systematic review article that has been used is the article by Fox et al., (2013) on the effectiveness of early discharge planning in acutely ill or injured old adults.

The practice issue that has been put forward is the development of a training plan for the older population regarding o the management of their condition after they are discharged. This is related to the topic under study since the readmission rates can be reduced by ensuring that the patients are able to manage their conditions at home.

The scope of practice can be described by the use of the PICOT question as indicated below

P (Population)- Old patients in the healthcare facility having acute illness or having an injury

I (Intervention)- The development of an early discharge planning for the patients

C (Comparison)- The use of usual care plan

O (Outcome)-  A reduction in the cases of readmission of older patients to the  hospitals

T (Time)- 3 months

__x_ Clinical

___ Education

___ Administration

___ Other (List):

_x__ Safety/risk management concerns

_x__ Unsatisfactory patient outcomes

___ Wide variations in practice

___ Significant financial concerns

___ Difference between hospital and community practice

__x_ Clinical practice issue is a concern

___ Procedure or process is a time waster

___ Clinical practice issue has no scientific base

__ Other:

The increasing cases of readmission of the elderly patients in hospitals have led to the increase in concerns. Along these lines, the problem has been identified from the concerns on the risks of readmission to the hospitals since it leads to an increase in costs of healthcare maintenance of the patient. Moreover, the expectations of the patients while being discharged is to ensure that there are no mistakes but the increase in the readmission has led to mistrust on the outcomes. The increase in readmission of elderly patients is as well an issue of concern in the medical practice.

___ Guidelines

___ Expert Opinion

___ Patient Preferences

___ Financial Analysis

___ Standards (Regulatory, professional, community)

___ Other

The increasing cases of readmission have mainly been identified to influence the elderly patients. Along these lines, there is a need for the development of measures that can be implemented in reducing the cases. The old population is mainly associated with longer stays in the healthcare facilities and the need for the development of an early discharge plan for the patients as elucidated by Fox et al., (2013) is a stepping stone for minimizing the cases of readmission.  Readmission has a variety of challenges include the fact that there is an increase in the cost of managing the healthcare conditions of the elderly patient. Moreover, readmission will put the quality of services offered in hospitals in question. As such, there will be a reduction in the trusts that the patients will have in the healthcare organization due to the readmission cases.

Fox, M. T., Persaud, M., Maimets, I., Brooks, D., O’Brien, K., & Tregunno, D. (2013). Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: a systematic review and meta-analysis. BMC geriatrics, 13(1), 70.

The aim of the study by Fox et al., (2013) is to assess the effectiveness of early discharge planning for the older patient show have been admitted with the acute illness or injuries.

Provide a statement of the questions being addressed in the work and how they relate to your practice issue:

What is the effectiveness of early discharge plan on the older patient show have been admitted with the acute illness or injuries?

The authors have presented that the intervention for minimizing readmissions on the healthcare organization is the provision of an effective plan that will help the patients in the transition after discharge. In this regard, the elderly patients are provided with a discharge plan from the time of their admission. The authors deduce that the availability of an early plan for the patients in comparison with the usual care helps in reducing the cases of readmission of the elderly patients. This is attributed to the fact that the there is an improvement in the quality of life of the patients who have had a discharge plan from the time of their admission.

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper.

The findings indicate that many studies have indicated that an early discharge planning is crucial at the time that the patients are in an acute state for the reduction of readmission. Specifically, the findings are applicable for old patients and are performed by the nurses within the first 24 hours before the patient is discharged. Along these lines, the patient does not get enough information on the ways of managing their condition. The discharged plans that have been identified to be supported by a variety of researchers include the assessment of the needs of the elderly patients while at home.

Moreover, the other discharge plans include the provision of education to the patients o the necessary adjustments that could help in reducing the cases or readmission and the transfer of information to the community health provided on the management of the care of the elderly patients. Additionally, the proposal of the follow-up plans is adduced to be of help in reducing the cases of readmission. The results indicate that the reviews indicated that the follow-up method that is identifiable include the use of telephone calls or a mobile phone application that could provide a report on the patient conditions.

Due to the intensity of the cases of readmission, the evidence based solution that will be proposed for the project is the education of the patients on the ways of managing their conditions before discharge. Along these lines, the patient should receive care from the nurses from the time of their admission to help in ensuring that there is enough information on the possible challenges that will be faced after their discharge. In addition, the patients should be educated on the effects of readmission on the psychological well-being and the cost of hospitalization. Moreover, the patients are trained on the use of technological devices such as the mobile application that reports the vital signs of the elderly patient or a regular basis. This will help the healthcare providers in monitoring the health of the patient.

Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project.

One of the limitations of the review is that there are limited study methods for the research topic. This is attributed to the fact that only nine studies have been used. The precision is as well influenced by the sample size and the conclusion made by the researchers may be affected by the fact that there is no heterogeneity. This will have an impact on the utilization of the article since it can be asserted that the issue at hand may not have had enough research studies in the past.  As such, the process of discharge planning may receive a measurable amount of resistance during the implementation.