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1. MSN 5650 MRU Reducing Hospital Readmission And Improving Quality Of
Care Capstone
MSN 5650 MRU Reducing Hospital Readmission And Improving Quality Of Care Capstone
ON MSN 5650 MRU Reducing Hospital Readmission And Improving Quality Of Care
Capstonehello: I want to know if you can fix the paper I attached below, it has all correction
of our professor, you just to fix and recheck the Powerpoint you sent me already.Words of
our professor (I want to be sure that you manage well the annotated comments by a faculty
and know how to make the corrections. I want a “clean paper” back. See the details in the
attached Grading document and Annotated paper.)MSN 5650 MRU Reducing Hospital
Readmission And Improving Quality Of Care Capstoneattachment_1Unformatted
Attachment PreviewRunning head: REDUCING HOSPITAL READMISSION 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 1 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 rehospitalization 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 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), reported 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

2. 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 the 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 as the previous cases in which patients received medication. A large part of the
growing cases of hospital readmissions has a strong link to 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). These
conditions tend to develop abruptly regardless of the time a patient has taken after
discharge from the hospital. Franckowiak, Raub and 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. Ideally, practitioners and healthcare administrators must plan
hospital discharge and postdischarge processes effectively. MSN 5650 MRU Reducing
Hospital Readmission And Improving Quality Of Care CapstoneOtherwise, an inappropriate
transition procedure may result in readmission cases (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

3. 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), who argue that
the unwillingness of 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. REDUCING HOSPITAL READMISSION 5 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 a 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). The practitioners
to have a professional responsibility to explain to the patients the details related to each
medication prescribed. Also, medication errors have been cited as one of the significant
causes of hospital readmission. MSN 5650 MRU Reducing Hospital Readmission And
Improving Quality Of Care CapstoneThe quality of services offered in a healthcare facility
depends on the degree to which errors are minimized (Yoder-Wise, 2018). 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 REDUCING HOSPITAL READMISSION 6 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. 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 services rendered to clients visiting the facility should be in

4. accordance with their medical conditions, and the health outcomes should be aligned with
the expected outcomes.. Understaffed healthcare facilities may not help in addressing these
ethical requirements. Inadequate amount of practitioners may not offer quality services
since they have diverted attention to 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. The nursing process is expected to be comprehensive,
running from assessment, diagnosis, plan, and interventions to recover the health wellness
of every individual. 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 REDUCING HOSPITAL
READMISSION 7 to manageable levels that would not warrant hospitalization. This strategy
is in line with the 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. The healthcare practitioners will be doing a beneficial action toward their patients
from the ethical point of view by helping the patients to understand the complexity of their
conditions and allowing them to participate in the strategies recommended to manage their
conditions and prevent reoccurrences. Those interventions could improve the quality of
care and may reduce the complications that bring the patients back to the hospitals
(Broadway, 2018). Additionally, there is a need for an adequate number of nurses and
physicians. MSN 5650 MRU Reducing Hospital Readmission And Improving Quality Of Care
CapstoneThis 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). A key component of ensuring adequate nursing
coverage should be offloading non-clinical activities from nursing staff to appropriate non-
clinical personnel, ensuring that clinical staff members can focus on patient care and
practice at the top of their license. When staff levels are higher, nurses may have: (1) more
time to spend with each patient, (2) a better documentation quality, (3) and reduced
opportunities for medical mistakes. Moreover, improving staffing, nurses could improve the
provider-patient/family communication REDUCING HOSPITAL READMISSION 8 and
provide assertive explanations of instructions during the discharge. All these actions related
to higher nursing staffing can help prevent hospital readmission down the road. Thus, the
facilities need to increase their staff to enhance quality service delivery, which is part of
ethical measures to be adopted in the hospitals. Regarding theclients’ medical information,
the healthcare facilities should guarantee that it will be securely stored to avoid the adverse

5. medical implications that come with the loss of the information and affecting the continuity
of care (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 healthcare facilities to
comprehensively address the health needs of the patients and medical errors resulting from
hurried treatment procedures. Having 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 REDUCING HOSPITAL READMISSION 9 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 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 rate of readmission cases would be an
indicator that the solution is effective in improving ethical standards in the hospitals. MSN
5650 MRU Reducing Hospital Readmission And Improving Quality Of Care CapstoneFurther
investigations regarding other factors affecting the readmission will be needed to correlate
the potential decrease of the hospital readmission to the implemented measure. 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
hospital readmission, the most notable being disengagement and non-compliance,
inappropriate transition procedures, the complexity of conditions, medication errors, and
healthcare provider shortage. Addressing the problem would be in line with the ethical
principle of beneficence. The principle will be based on the benefit that s healthcare
facilities provide their clients’ by REDUCING HOSPITAL READMISSION 10 rendering the
best quality in their services, promoting wellness, and preventing 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

6. 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).
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Tomescu, M. C., Ancusa, O., & Marincu, I. (2015). Causes and predictors of hospital
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Leading and Managing .MSN 5650 MRU Reducing Hospital Readmission And Improving
Quality Of Care Capstone