course materials

1. MSN 5650 Miami Regional University Reducing Hospital Readmission
Presentation
MSN 5650 Miami Regional University Reducing Hospital Readmission Presentation ON
MSN 5650 Miami Regional University Reducing Hospital Readmission
PresentationPowerPointKEY COMPONENTS:– Title & authors– Purpose and goals of the
presentation– Identification of the ethical problem and nursing context– Ethical concepts
involved– Ethical Decision-Making Process: steps– Evaluation of the ethical decision made–
Conclusion– References– QuestionsNotes:In general, all groups are advised to review the
annotations in the Final Paper to improve the focus and organization of the presentation,
and also to solve any gap in the ethical decision-making process they may have.30 minutes
maximum of every group including the time for questions at the end.Please, take the time to
review the whole presentation (content, key components, organization, APA and grammar,
add speaker notes for later reference while we are giving the presentation in public. No
more than 300 words.)ATTACHED YOU WILL FIND OUR FINAL PAPER AND THAT IS THE
INFORMATION THAT WE WANT IN THE POWERPOINT WITH ALL OF THESE
SPECIFICATIONS WE HAVE EXPOSED HERE.MSN 5650 Miami Regional University Reducing
Hospital Readmission Presentationattachment_1Unformatted Attachment
PreviewREDUCING HOSPITAL READMISSION 1 Reducing Hospital Readmission and
Improving Quality of Care Alain Leon Anaelis Travieso Andres Pareja Dagmara Lima
Eduardo Gonzalez Mailin Quinones Michel Gonzalez Reinel Romero Salvador Sanchez Yaima
Hernandez Yarisvey Mendoza Miami Regional University MSN5650 Nursing Decision
Making Dr. Idania Martin, DNP, APRN, ANP-BC REDUCING HOSPITAL READMISSION 2
Reducing Hospital Readmission and Improving Quality of Care Hospital readmission rates
are the most-cited indicators of establishing the quality of services offered by healthcare
facilities. Although readmission is a widely used term, it lacks a standardized and universal
time frame for reporting cases as readmissions by Yu, Mamey, and Russell (2017). Some
healthcare facilities and organizations have their readmissions’ interpretations from 24
hours to 1 year upon discharge from a facility (Hughes, & Witham, 2018). The absence of
uniform criteria makes the term confused with other related terms, such as re-
hospitalization and unscheduled admissions. However, most healthcare facilities view
readmission as any case in which a patient is brought back to a hospital for the same or
related causes 30 days after discharge (Hughes & Witham, 2018). Diseases and sicknesses
that result in readmission may be the same or similar to the previous cases in which

2. patients received medication. There are the increasing cases of hospital readmission, most
of them having a strong link to low quality of services. According to El Morabet et al. (2018),
three percent of patients visiting a hospital within 30 days are readmitted in the same or
different facilities over cases related to the previous health challenges. Kry?, ?yszczarz,
Wyszkowska, and K?dzioraKornatowska, (2019), MSN 5650 Miami Regional University
Reducing Hospital Readmission Presentationreported a similar prevalence and stressed
that at least three to 25 percent of readmission cases refer to drug misdiagnosis and 30
percent of the cases reported are preventable. An increase led to the development of
readmission reduction programs by the Medicaid to financially hospitals experiencing
cases to enable them to improve the quality of services they offer (Fonarow, Konstam, &
Yancy, 2017). The initiative has helped in creating interventions for the problem. Therefore,
it is essential to look at major causes of hospital readmission and evaluate the available
options to minimize the cases. REDUCING HOSPITAL READMISSION 3 Ethical Decision-
Making Process Description of the Problem Patients expect to receive quality services upon
visiting healthcare facilities, and it is the role of healthcare practitioners to ensure the
wellness of clients. Hospital readmission is one of the challenges experienced in the health
sector. Several causes attributed to hospital readmissions. Disengagement and non-
compliance, inappropriate transition procedures, the complexity of conditions, and
medication errors are the most cited reasons for the increasing cases of readmissions
(Fonarow, Konstam, & Yancy, 2017). In this connection, one of the ethical considerations for
healthcare facilities is to ensure addressing patients’ health needs, especially when the
latter pay costly to access them. Another ethical consideration is preserving human life by
providing the best services to ensure patients’ wellness. Patient segmentation, improving
transition systems, reducing medical errors, and adequate staffing are some solutions to
hospital readmission, with the latter being the most effective strategy (Hughes &
Witham,2018). Diseases and sicknesses that result in readmission may be the same or like
the previous cases in which patients received medication. A large part of the growing cases
of hospital readmissions, has a strong link to a low quality of the services previously
received. Description of Ethical Considerations Several factors have cited as the root causes
of hospital readmissions. First, the complexity of conditions on the part of patients may
contribute to the cases of readmission (Sportsman, 2014). A significant portion of
individuals with severe conditions, such as pneumonia, kidney failure, sepsis, and heart
failure, report high cases of hospital readmission (Hughes & Witham,2018). MSN 5650
Miami Regional University Reducing Hospital Readmission Presentationconditions tend to
develop abruptly regardless of the time a patient has taken after discharge from the
hospital. Franckowiak, Raub & Yost (2019) asserted REDUCING HOSPITAL READMISSION 4
that some conditions might develop severe complications when patients fail to adhere to
the management practices recommended by physicians. These arguments are in line with
those by Ma et al. (2018), who stated that patients’ failure to follow treatment schedules
might complicate their conditions, thereby leading to preventable readmissions. It is ethical
for the practitioners to help the patients understan the complexity of their conditions
(Broadway, 2018). This strategy would help the clients to understand the best strategy of
managing their conditions and the possible prevention of reoccurrences. Moreover,

3. inappropriate transition procedures may result in readmission cases. Ideally, practitioners
and healthcare administrators must plan hospital discharge and post-discharge processes
effectively (Sportsman, 2014). The transition may include empowering patients on
appropriate self-management practices they should adopt upon leaving a facility. Also,
medical practitioners are required to plan for home visits, follow-up appointments, and
ensure that patients have detailed, clear, and easy to understand instructions (Jamei et al.,
2018). Patients need to adhere to these instructions for the realization of their desired
wellness. It is an ethical requirement for the practitioners to ensure that a positive
transition of the patients from the facility to home-based care (Franckowiak et al., 2019).
They are also required to ensure that the patients’ environment is not harmful since this is
part of the nursing principles that require the nurses to avoid harming the patients
(Broadway, 2018). In this situation, harming may expose the clients to the harmful
environment, especially when referring them to home-based care. Patients leaving a
healthcare facility need to be aware of what they should do in managing their conditions.
Jamei et al. (2018) state that leaving a healthcare facility with piles of papers where it is
difficult to interpret information is one cause of hospital readmission. These arguments are
in line with the assertions by Yu, Mamey, and Russell (2017), they argue that the
unwillingness of REDUCING HOSPITAL READMISSION 5 the patients to adopt sound
healthcare practices may be due to a healthcare practitioner’s failure to give clear
instructions on self-management practices. As a result, clients make selfmedication errors
that may compromise their wellness, thus making them return to hospitals. Inappropriate
transition procedures result in the misinterpretation of discharge instructions. According to
Hughes and Witham (2018), many patients are readmitted to healthcare facilities due to a
failure to accurately interpret drug dosage instructions and other recommendations related
to healthcare practices. Ma et al. (2018) argued that non-compliance cases result from
patients’ unwillingness to participate in sound care practices. However, Hughes and Witham
(2018) disagreed with these assertions and state that non-compliance results from a failure
to interpret medical instructions issued at medical facilities and not from patient’s lack of
knowledge. Most of the patients opt to forego medications, especially when they fail to
understand their purpose, dosage, and mode of intake (Sportsman, 2014). Therefore, it is
ethical for the practitioners to explain to the patients the dosage for each medication.
Ethically, the nursing process is expected to be comprehensive, running from diagnosis,
treatment to recovery. It is thus essential for the nurses to ensure that the clients are
exposed to all-round care. When staff levels are higher, nurses have more time to spend
with each patient, ensuring more comprehensive communication. MSN 5650 Miami
Regional University Reducing Hospital Readmission PresentationThis often increases the
quality of discharge instructions provided, which can help prevent readmission down the
road. A key component of ensuring adequate nursing coverage should be offloading
nonclinical activities from nursing staff to appropriate non-clinical personnel, ensuring that
clinical staff members are able to focus on patient care and practice at the top of their
license. Also, medication errors have been cited as one of the significant causes of hospital
readmission. The quality of services offered in a healthcare facility depends on the degree to
REDUCING HOSPITAL READMISSION 6 which errors are minimized (Yoder-Wise, 2018).

4. Several factors contribute to medication errors. First, patients’ history may not be
considered when making an assessment and diagnosing their present conditions. A failure
to conduct an in-depth analysis of the present and past medical conditions may result in
partial treatment of the prevailing conditions, thereby resulting in future readmissions (El
Morabet et al., 2018). Errors may also result from inaccurate documentation of a patient’s
data. There are increasing cases of patients’ data being wrongly filed, lost, or used for
another client (Yoder-Wise, 2018). Nursing ethics require practitioners to refrain from
harming patients. Therefore, they are expected to carry out accurate diagnoses and adopt
appropriate treatment approaches likely to prevent harm to patients. According to Hughes
and Witham (2018), some medication errors originate from nurses’ lack of knowledge or
other medical practitioners. Some patients are harmed during a treatment process,
discovered later after discharged from a facility (Kry? et al., 2019). For instance, there are
cases when catheters are left in patients’ bodies after surgery. Such errors may have
devastating effects, which in turn results in readmission. It is an ethical requirement for the
practitioners to provide the best services to ensure the wellness of the patients. A
significant portion of medical errors is preventable, meaning that effective medical
procedures can help minimize readmission cases. Evaluation of Solutions Several strategies
can help reduce readmission cases in medical facilities, as a need for medical practitioners
to segment their patients based on the degree of high risk to readmission. According to
Hughes and Witham (2018), some facilities are likely to report readmission cases than
others. Mavrea et al. (2015), opined that it is necessary to monitor individuals at high risk of
hospital readmission and give them exceptional quality services that could suppress
conditions to manageable levels that would not warrant hospitalization. This strategy is in
line with the REDUCING HOSPITAL READMISSION 7 medical ethics that require
practitioners to provide quality services likely to address the health needs of their clients.
Shahida et al. (2016) argued that follow-up plans and regular appointments should be
incorporated into management plans after patients are discharged from healthcare
facilities. The plans would help in the realization of comprehensive care for patients, aligned
with ethical care practices in nursing. Close monitoring and the provision of quality services
may, therefore, minimize readmission cases. MSN 5650 Miami Regional University Reducing
Hospital Readmission PresentationAdditionally, there is a need for an adequate number of
nurses and physicians. This strategy is one of the most effective methods of improving the
quality of services and reducing readmission rates (Yoder-Wise, 2018). All healthcare
facilities should have adequate staffing, especially for nurses. The nurses are contact
persons between patients and physicians. It is thus very unlikely to deliver quality services
in facilities having a nurse shortage (Sportsman, 2014). It is ethical to ensure that the
services provided in the healthcare facilities are beneficial to the patients. The nursing
principles also provide that the clients visiting the facility should be accorded with services
that meet their desired health outcomes. Understaffed healthcare facilities may not help in
addressing these ethical requirements. Inadequate practitioners may not offer quality
services since they have diverted attention on which patients to serve at a particular time
(Sportsman, 2014). The hurried approach to treatment to attend to all patients may lead to
a failure to meet clients’ needs. Thus, the facilities need to increase their staff to enhance

5. quality service delivery, which is part of ethical measures to be adopted in the hospitals.
Furthermore, there is a need for improving transition care as one way of reducing
readmission cases. Kry? et al. (2019) argued that a significant portion of the patients leaves
healthcare facilities without clear instructions on effective ways of managing their
conditions. Similarly, Shahida et al. (2016) state that cases of non-compliance on the part of
the patients are REDUCING HOSPITAL READMISSION 8 attributed to a lack of effective
transition process during discharge. There is a need for healthcare facilities to develop
strategies that would ensure the preparation and implementation of followup plans. The
strategy would require a section of nurses and others healthcare practitioners to work in
the field by visiting homes and ensuring patients’ adherence to medical schedules by
patients. Moreover, healthcare facilities should adopt measures to reduce medical errors,
which must be caused by healthcare practitioners. The loss of patients’ data, the
misplacement of vital diagnostic information, and the lack of knowledge of medical
practitioners refer to the reasons for medication errors in healthcare facilities (El Morabet
et al., 2018). Patients who develop complications due to surgical procedures or those who
have been administered with wrong medications due to data misplacements are likely to
return to hospitals to seek medications over the same or related medical conditions
diagnosed previously. It is the right of patients to be accorded quality care (Yoder-Wise,
2018). Also, it is ethical for the clients’ data to be securely stored in the healthcare facilities
to avoid the adverse implications that come with the loss of the information (Sportsman,
2014). The healthcare facilities should adopt electronic information systems to record and
store data and do on-job training to improve their staff’s competence. Choosing a Solution
The best alternative is ensuring that facilities have adequate and competent staff.
YoderWise (2018) asserts that adequate staff would help improve the quality of services
offered hence aligning with the ethical requirements that require facilities to ensure that
the patients receive satisfactory care. The quality of services in health facilities depends on
the extent to which available medical practitioners can comprehensively address the needs
of patients (Shahida et al., 2016). El Morabet et al. (2018) allude that readmission cases are
a result of the failure of the REDUCING HOSPITAL READMISSION 9 healthcare facilities to
comprehensively address the health needs of the patients and medical errors resulting from
hurried treatment procedures. MSN 5650 Miami Regional University Reducing Hospital
Readmission PresentationHaving enough personnel is also in line with the ethical
workforce management practice that requires organizations to have adequate staff to
prevent cases of burnout, which may compromise the health status of the existing
employees (Sportsman, 2014). Therefore, adequate staffing would ensure that every client
is accorded due attention while also minimizing the cases of prolonged waiting time
associated with hospitalacquired infections and subsequent readmissions. Implementing
the Solution The healthcare facilities need to ensure that each department has competent
practitioners. Also, those on transfers and resignations need to be timely replaced to reduce
staff shortage. An adequate number of staff members would also help in the comprehensive
assessment and diagnosing of patients to establish all underlying health challenges. The
analysis would then lead to comprehensive care, which reduces the cases of partial
treatments and their associated readmissions. Therefore, employing an adequate and

6. competent staff would reduce the workload of the existing medical practitioners, thereby
enhancing their good health (Shahida et al., 2016). The evaluation of the solution should pay
attention to establishing the number of patients readmitted in the facility and their
satisfaction levels. Increased levels of patients’ satisfaction with the services offered and
low cases of readmission would be an indicator that the solution is effective in improving
ethical standards in the hospitals. Conclusion Hospital readmission occurs when patients
are taken back to healthcare facilities over cases similar to those previously treated within a
short period. There are several causes of REDUCING HOSPITAL READMISSION 10 hospital
readmission, the most notable being disengagement and non-compliance, inappropriate
transition procedures, the complexity of conditions, and medication errors (Fonarow,
Konstam, & Yancy, 2017). Addressing the problem would be in line with the ethical
requirements that require healthcare facilities to provide the best services to promote their
clients’ wellness to prevent the loss of life. Patient segmentation, improving transition
systems, reducing medical errors, and adequate staffing are some solutions to the problem
(Hughes & Witham,2018). Adequate staffing may be the most effective solution, considering
that its implementation would mitigate other causes of hospital readmission. The strategy
also adheres to the ethical requirements of enhancing the workforce’s welfare and patients
in healthcare facilities. REDUCING HOSPITAL READMISSION 11 References Broadway, M. A.
(2018). Legal and Ethical Issues. Leading and Managing in Nursing-E-Book, 32. El Morabet,
N., Uitvlugt, E. B., van den Bemt, B. J., van den Bemt, P. M., Janssen, M. J., & Karapinar?Çarkit,
F. (2018). Prevalence and preventability of drug?related hospital readmissions: A
systematic review. Journal of the American Geriatrics Society, 66(3), 602-608.
https://doi.org/10.1111/jgs.15244 Fonarow, G. C., Konstam, M. A., & Yancy, C. W. (2017).
The hospital readmission reduction program is associated with fewer readmissions, more
deaths: Time to reconsider. Journal of the American College of Cardiology, 70(15), 1931-
1934. http://dx.doi.org/10.1016/j.jacc.2017.08.046 Franckowiak, T. M., Raub, J. N., & Yost,
R. (2019). Derivation and validation of a hospital allcause 30-day readmission index.
American Journal of Health-System Pharmacy, 76(7), 436-443.
http://dx.doi.org/10.1093/ajhp/zxy085 Hughes, L. D., & Witham, M. D. (2018). Causes and
correlates of 30-days and 180-day readmissions following discharge from medicine for the
elderly rehabilitation unit. BMC Geriatrics, 18(1), 197. http://dx.doi.org/10.1186/s12877-
018-0883-3 Jamei, M., Nisnevich, A., Wetchler, E., Sudat, S., Liu, E., & Upadhyaya, K. (2018).
Correction: Predicting all-cause risk of 30-day hospital readmission using artificial neural
networks. PloS One, 13(5), e0197793. http://dx.doi.org/10.1371/journal.pone.0197793
Kry?, J., ?yszczarz, B., Wyszkowska, Z., & K?dziora-Kornatowska, K. (2019). Prevalence,
reasons, and predisposing factors associated with 30-day hospital readmissions in
REDUCING HOSPITAL READMISSION 12 Poland. International Journal of Environmental
Research and Public Health, 16(13), 2339. http://dx.doi.org/10.3390/ijerph16132339 Ma,
C., Shang, J., Miner, S., Lennox, L., & Squires, A. (2018). The prevalence, reasons, and risk
factors for hospital readmissions among home health care patients: A systematic review.
Home Health Care Management & Practice, 30(2), 83-92.
https://doi.org/10.1177/1084822317741622 Mavrea, A. M., Dragomir, T., Bordejevic, D. A.,

7. Tomescu, M. C., Ancusa, O., & Marincu, I. (2015). Causes and p …MSN 5650 Miami Regional
University Reducing Hospital Readmission Presentation