Publication Date

2024

Document Type

Dissertation/Thesis

First Advisor

Cooke, Marcia

Second Advisor

Goetz, Elizabeth

Third Advisor

Tanzillo, Tanya

Degree Name

DNP (Doctor of Nursing Practice)

Department

School of Nursing

Abstract

Background: Frequent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can lead to unfavorable patient outcomes and costly readmissions. Inadequate patient support during discharge and an inconsistent discharge process are factors contributing to high readmissions in this population.

Purpose: This quality improvement project aimed to reduce COPD-related hospital readmissions by standardizing the discharge process for patients admitted with AECOPD and identify patient risk factors for readmission.

Methods: Following a quantitative and quasi-experimental design, this project standardized the discharge process for patients admitted with AECOPD using the Re-Engineered Discharge Toolkit components and a discharge care bundle. The project was executed at a respiratory unit of a small community hospital for over eight weeks. The sample (n=26) consisted of adult patients admitted to the respiratory unit with a principal diagnosis of AECOPD. The outcome measure was the 30-day COPD readmission rate of the respiratory unit.

Results: The respiratory unit’s 30-day COPD readmission rate was lowered by at least 7% from baseline after implementation of the intervention. Not getting the pneumonia vaccine was a significant patient risk factor for readmission.

Conclusion: The implementation of the RED Toolkit components and a discharge care bundle to standardize the COPD discharge process demonstrated some effectiveness in reducing the 30-day COPD readmission rate. However, data is not sufficient to clearly identify readmission risk factors and which component(s) of the discharge process was most effective in reducing patient readmission.

Keywords: COPD readmissions, Re-Engineered Discharge Toolkit, discharge care bundle, discharge process

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