Nursing Intervention Paper

The overall process of discharging a patient from a hospital and the transition back home or to a care facility are critical advancements in the overall course of both acute and long-term care. It is important that the hospitals releasing these patients have ensured the proper overall course of care from beginning to end. The lack of consistency with both the discharge process and the quality of discharge planning has led to many avoidable readmissions. To reduce the amount of hospital readmissions, it is imperative that hospitals recognize the need for focused patient care and that programs are being implemented to assist in the care transition.

The purpose of this paper is to conduct an in depth exploration of the nursing care considerations of patients in a specific clinical area. Through the synthesis of prior knowledge, clinical experiences and skills, evidence based best practices, and care of patients a comprehensive care and teaching plan will be composed. Integration of critical thinking and clinical reasoning skills, combined with evidence-based research will provide confirmation of nursing process comprehension. The inclusion of reviewed literature will further support knowledge and understanding.

The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.

There are many interventions that can assist an ME sufferer in improving their occupational imbalance and regaining a sense of identity.

Readmission to a hospital creates strain and added expense for the patient and hospital; in 2011, hospital costs due to readmission were almost $41.3 billion (Hines, Barrett, Jiang, & Steiner, 2014; Rau, 2014). There are many aspects of healthcare associated with readmission, such as lack of discharge planning and education, which need to be addressed i to decrease the amount of preventable re-hospitalizations.

This model reimburses hospitals based on quality of care instead of the volume of patients. The quality of care is assessed by patient questionnaires and if hospitals are unsatisfactory penalties may be imposed (Edwoldt, 2012). The value-based system also affects Medicare and Medicaid. It was reported that Medicare readmissions within 30 days of discharge cost 17 billion dollars annually (Edwoldt, 2012). Due to the high costs of readmissions Medicare and Medicaid have implemented a Hospital Readmission Reduction program. A formula is utilized to evaluate readmission rates within 30 days of discharge for any medical reason related to their original admission such as heart failure and pneumonia. Upon review the hospital is potentially penalized. It is important that nurses strive to provide excellence in care despite their beliefs on the ACA. Nurses have the ability to provide a safe patient environment and reduce the risk of hospital associated infections by following hospital protocols such as hand washing.

In 2013 an average of one out of eight Medicare patients are readmitted within a 30-day period which lead to the estimated costs of around $18 billion a year for Medicare patients alone. Hospitals will either be penalized or receive bonuses for their performance with readmissions. This program will encourage hospitals to concentrate on ways to improve coordinating transitions of care while improving the safety and quality of care provided. In order to

A systematic review was conducted to compare patient outcomes after transitioning out of the hospital to another facility, home independently and home with support. Transitioning home with support was more beneficial than transitioning home independently and the reviews were mixed for home with support or transitioning to another facility (Boland, L., Briere, N., Emond, J., Garvelink, M., Guerard, Legare, F., G., McIsaac, D., Menear, M., Perez, M., Stacey, D., 2017).

The aim of the Affordable Care Act (ACA) is to reduce hospital readmission and to increase implementation of transitional care coordination for low health care cost. One benefit of establishing this

There is a problem of avoidable hospital readmission rates for the Medicare and Medicaid populations that lead to adverse consequences not only for the patient, but also the payer and hospital. In order to decrease these avoidable readmission rates it is important to identify processes that can be implemented at the health plan level such as pre-discharge hospital visits by health plan staff, and post-discharge care coordination.

For Medicare, readmissions are defined as an admission to an acute care hospital within 30 days of discharge from an acute care hospital (Horwitz, L. et al, 2011). Factors affecting unplanned readmissions vary greatly among providers and geographical region, and are opportunities increase quality and coordination of care, thus improving health outcomes. In 2005, the Medicare Payment Advisory Commission (MedPAC) conducted the Medicare Claim Finding analysis; MedPAC surveyed hospital Medicaid claims to analyze their hospital readmission data. This research from MedPAC showed that 75% of Medicare admissions were preventable and 17.6% of Medicare admissions resulted with a readmission within 30 days (MedPAC, 2011). Furthermore, this large percentage of preventable admissions were taking a toll on payers financially. The cost of these 75% preventable readmissions amounted to fifteen billion dollars (MedPAC, 2011). This data raises concern regarding the financial burden of unnecessary admissions as well as quality issues. Due to the high cost and decreased quality of hospital

The hospital readmission (HR) may be regarded as an indicator of the quality of hospital care and, indirectly, of primary care. Some factors may foster HR, such as low quality of supportive care, early discharge, lack of treatment adherence on the part of users and their families, age, absence of specific guidance and post-discharge follow-up, as well as socioeconomic and cultural conditions. Therefore, in order to perform a resolute care, one needs to know the profile of admissions and of HR, thereby enhancing the planning and the implementation of strategies. In order to raise the aforementioned questions, this study had the purpose of analyzing the profile of readmissions of children treated in the pediatric sector of the Regional Hospital in Ceilândia (HRC) in March, April and May 2015. This

Hospital readmission rates are thought to be a representation of poor quality and efficient care. Readmissions have become recognized as an emerging concern as they place a financial burden on the system as well as a personal burden on the patient and their family. Of patients that are discharged from hospitals, 19.4% will be readmitted within thirty days and 51.6% will be readmitted within one year (Roberts & Robinson, 2014). Reducing readmissions is very important to decrease costs for the patient and the facility, ensure hospitals are providing quality care, and decreasing the risk of the patient suffering from a secondary infection or injury. Every discipline plays a vital role in reducing readmission rates, including therapists and health

o Conceptual model or theoretical framework: In what way was a conceptual model or theoretical framework used to guide this study?

For years, healthcare costs have continued to increase in the United States and policymakers are constantly trying to find ways to reduce spending. According to reports, in 2011, about $900 billion out of the $2.6 trillion annual health care spending was wasteful spending. In the following year, there was a reported $690 billion wasted annually on healthcare. This wasteful spending is attributed to ineffective health care delivery, cost of adverse events, and poor care coordination that has led to avoidable readmissions (Lallemand, 2012). In the United States, readmissions are the highest amongst patients with chronic diseases accounting for about 90% of avoidable readmissions in 30 days after discharge, and costing the industry an estimated $17 billion. These readmissions are a result of inadequate discharge planning, lack of follow-up, and lack of education on disease management (Jayakody et al., 2016). Policymakers on the federal and state level have developed and implemented several programs, some varying state to state, to help reduce wasteful spending while improving quality of care.