Doctor of Nursing Practice (DNP)
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College of Nursing
Publication Date / Copyright Date
Nova Southeastern University
Folasade Omobowale Adewunmi. 2019. Improved Use of Interact to Decrease 30-Day Readmissions from a Skilled Nursing Facility. Capstone. Nova Southeastern University. Retrieved from NSUWorks, College of Nursing. (59)
Background: The rising cost of health care in relation to rehospitalizations continues to be a challenge. Medicare 30-day readmissions have an annual estimated cost of $17.4 billion. Irrespective of these costs and the continued improvement in the quality of care, skilled nursing facilities (SNF) still face high readmission rates. Purpose: The purpose of this quality improvement project was to enhance SNF care processes by improving the utilization of the electronic medical record software program “INTERACT” to increase early identification and treatments of patients to minimize 30-day hospital readmissions. Theoretical Framework: The theory of planned behavior by Icek Azjen was used. Methods: Project design: This project used a pretest and posttest design to assess for improvement in the use of the INTERACT tools and increased nursing proficiency after participating in a 45-minute INTERACT training session. A 60-day retrospective and prospective rehospitalization rates data were also compared. Results: After the training, there was a statistically significant improvement in the number of nurses using the INTERACT tool. The two-tailed paired sample t-test result showed a significant difference in the use of the INTERACT clinical decision support tools: Pretest (M = 2.08, SD = 0.88) and posttest (M = 1.33, SD = 0.63), t(23) = 3.30, p = .003. There was no statistical difference in the proficiency of nurses post the training. This result is associated to probable data loss and/or limited time for data collection. Although a 15% decrease in SNFs rehospitalizations rates was noted, there is no direct causative explanation that increased nurses use of the tool significantly contributed to the reduction in rehospitalization rates among other factors. Conclusion: The INTERACT program has contributed by improving early identification and treatment of patients and facilitated improved patient outcomes and nursing care processes. It is assumed that as nurses begin to build up their use of the INTERACT support tools, this tool will result in an increase in proficiency, which will increase responsiveness to change in condition and a corresponding decrease in avoidable rehospitalizations.
Health and environmental sciences, Change in clinical condition, Cost of healthcare, Interact program, Proficiency in nursing care, Readmission rates, Rehospitalization rates
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