NURS FPX 6030 Assessment 6 Final Project Submission.pdf

Assessment 6: Final Project Submission
Student Name
Capella University
NURS-FPX 6030 MSN Practicum and Capstone
Prof. Name
June 25, 2024
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Project Conclusion Report
Summary
The objective of this project was to improve patient understanding of discharge
instructions, decrease hospital readmissions, and enhance patient satisfaction
following cardiac catheterization. A customized educational program, coupled with
remote healthcare services, was implemented to address knowledge gaps and provide
ongoing support to patients after discharge. The initiative included personalized
discharge instructions and utilized a variety of educational methods such as audiovisual
tools, remote monitoring devices, and communication platforms. The findings
emphasized the crucial role of nurses in patient education and demonstrated a positive
correlation between enhanced patient education and reduced hospital readmissions,
which could lead to significant cost savings for healthcare providers.
Project Initiation
This initiative focused on addressing the high 30-day readmission rates among
Coronary Artery Disease (CAD) patients discharged after cardiac catheterization at
Manatee Memorial Hospital in Bradenton, Florida. The project aimed to improve patient
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education post-discharge by providing personalized instructions and utilizing telehealth
services to reduce readmissions. The intervention strategy was guided by
transformational leadership, adhered to regulatory standards such as HIPAA and HRRP,
and was designed to be implemented over 12 to 18 months.
Problem Statement
The study compared a comprehensive, tailored post-discharge education program with
standard discharge instructions to evaluate their impact on 30-day readmission rates
and patient outcomes. The importance of reducing readmission rates for PCI patients
was highlighted by Madan et al. (2019).
Population and Setting
The target population for this project was patients discharged after cardiac
catheterization at Manatee Memorial Hospital. The tailored approach was designed to
minimize complications, reduce readmission rates, and improve patient satisfaction
across a diverse patient population.
Intervention Overview
The project proposed two key interventions: personalized discharge education and
telehealth services. The Plan-Do-Check-Act (PDCA) cycle was employed to develop a
customized post-cardiac catheterization education program, which included medication
management, lifestyle modifications, symptom recognition, and timely follow-up
appointments.
Comparison of Methods
The intervention underscored the importance of interprofessional collaboration to
ensure comprehensive patient care. Tailored educational plans were compared to other
approaches, such as standardized education programs and group sessions led by
interprofessional teams.
Initial Outcome Goals
The project set several outcome goals, including a 20% reduction in 30-day readmission
rates, a 15% increase in medication adherence, a 30% increase in follow-up
appointments, and a 25% improvement in timely symptom reporting.
Time Estimate
The timeline for the development and implementation of the education program was
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estimated at approximately 12 months, encompassing phases of planning, platform
development, pilot testing, and full-scale implementation.
Literature Review
The literature review highlighted the effectiveness of personalized post-procedure
patient education, emphasizing the significance of individual health literacy and cultural
considerations. The review also recognized the value of current telehealth policies and
remote monitoring tools in providing ongoing, personalized support to patients.
Intervention Strategy
The strategy focused on delivering comprehensive and customized discharge education
by integrating tailored educational programs with telehealth services. Cultural factors
and theoretical frameworks, such as Dorothea Orem’s Self-Care Theory, were considered
in the development of the intervention.
Stakeholders, Policies, and Regulations
Key stakeholders included patients, healthcare providers, administrators, and external
entities such as insurance companies. Policies like HIPAA and HRRP were essential for
ensuring patient confidentiality, data security, and regulatory compliance.
Ethical and Legal Considerations
Ethical considerations involved balancing patient autonomy with beneficence, while
legal considerations focused on adhering to HIPAA regulations during telehealth
interactions.
Implementation Plan
Leadership and management strategies emphasized transformational leadership,
interdisciplinary training, project planning, and patient-centered care throughout the
implementation process.
Impact on Outcomes and Cost-effectiveness
The anticipated outcomes included improved patient satisfaction, reduced readmission
rates, and enhanced care coordination, all of which could result in cost savings for
healthcare organizations.
Delivery Methods and Technology
The project explored a combination of in-person and digital methods for delivering
personalized discharge education and telehealth services. Traditional methods, such as
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one-on-one consultations and group sessions, were augmented by advanced
technologies, including augmented reality (AR), virtual reality (VR), digital resources,
virtual platforms, personalized apps, and wearable devices.
Technological Alternatives
Existing technologies, such as PowerPoint presentations and interactive videos, were
compared to emerging technologies like AR, VR, personalized apps, and wearable
devices, with an acknowledgment of the potential challenges associated with these
innovations.
Stakeholders, Policies, and Regulations
Critical stakeholders included patients, caregivers, healthcare professionals,
administrators, IT professionals, insurance providers, and regulatory bodies. Engaging
these stakeholders was crucial for ensuring adequate resource allocation, budget
management, and technological support.
Current and New Policies
Existing policies, including telehealth reimbursement, support the financial sustainability
of telehealth services, enhancing patient access. Standardizing digital health
educational materials is critical for ensuring consistent information dissemination.
Policies that promote collaborative care and interdisciplinary teamwork could be
developed, and the Affordable Care Act (ACA) could provide funding and resources for
underserved communities to access telehealth services.
Schedule
The proposed timeline for implementing the comprehensive discharge education plan
was 12-18 months, contingent on factors such as patient needs, resource availability,
stakeholder engagement, patient readiness, and technological infrastructure.
Adjustments may be required based on unforeseen challenges.
Evaluation Strategy
The evaluation plan included the development of a tailored educational program and the
integration of telehealth services. Outcomes were to be assessed through
pre-intervention questionnaires, follow-up assessments at 1, 3, and 6 months, and
comparisons with a control group receiving standard discharge instructions. Data
collection involved patient feedback forms, hospital readmission records, Electronic
Health Records (EHRs), and patient portals, with advanced analytics used for
comprehensive evaluation.
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Discussion
Nurses are positioned as key leaders in driving change and innovation. The intervention,
with its focus on customized education, enhances the nurse’s role in simplifying
complex medical instructions. Nurses become central knowledge brokers, leading to a
shift toward personalized patient education. This change strengthens interprofessional
collaboration and builds trust and reputation for healthcare institutions. For post-cardiac
catheterization patients, the intervention fosters a thorough understanding of their
recovery, empowering them for long-term health. Challenges include ensuring
comprehensive nurse training and consistent delivery of high-quality education.
Future Steps
To maximize the intervention’s impact, future steps include further personalization of
educational content, incorporating AR and VR systems for immersive learning, and
adopting the Chronic Care Model (CCM) for proactive health management. Integrating
AI-driven monitoring systems could predict potential issues for early intervention.
Challenges include technology readiness, effectiveness, resource constraints, and
patient adaptation.
Reflection on Leading Change and Improvement
Engaging with this project has significantly enhanced my leadership abilities,
highlighting the importance of personalized patient care. It has bolstered my confidence
in leading change, guiding teams, and making patient-centric decisions. The project’s
challenges and successes have provided valuable insights for future leadership roles.
The framework developed can be applied across various patient care settings,
contributing to continuous quality improvement. The emphasis on personalized care
remains central to effective interventions. Ongoing learning and addressing knowledge
gaps are essential for successful leadership in healthcare.
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References
Bolton, C., Vikram Kandhari, & Coolican, M. (2021). Medical optimization of the patient
prior to surgery. Springer, 241–252. https://doi.org/10.1007/978-3-030-81553-0_24
Chen, A., Ayub, M. H., Mishuris, R. G., Rodriguez, J. A., Gwynn, K., Lo, M. C., Noronha, C.,
Henry, T. L., Jones, D., Lee, W. W., Varma, M., Cuevas, E., Onumah, C., Gupta, R., Goodson,
J., Lu, A. D., Syed, Q., Suen, L. W., Heiman, E., … Schmidt, S. (2023). Telehealth policy,
practice, and education: A position statement of the society of general internal
medicine. Journal of General Internal Medicine, 1–8.
https://doi.org/10.1007/s11606-023-08190-8 CMS. (2023).
Hospital readmissions reduction program (HRRP).
https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/r
eadmissions-reduction-program Jung, C., Wolff, G., Wernly, B., Bruno, R. R., Franz, M.,
Schulze, P. C., Silva, J. N. A., Silva, J. R., Bhatt, D. L., & Kelm, M. (2022).
Virtual and augmented reality in cardiovascular care. JACC: Cardiovascular Imaging,
15(3), 519–532. https://doi.org/10.1016/j.jcmg.2021.08.017 King-Dailey, K., Frazier, S.,
Bressler, S., & King-Wilson, J. (2022).
Nurse practitioners' role in managing heart failure patients and programs. Current
Cardiology Reports, 24(12), 194–1956. https://doi.org/10.1007/s11886-022-01796-0
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