Health Sciences Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences – Health Science Department

First Advisor

Akiva Turner

Second Advisor

Moya Alfonso

Date of original Performance / Presentation

January 2023

Publication Date / Copyright Date

1-1-2023

Abstract

Hospital readmissions within 30 days for patients discharging home from a short stay at a skilled nursing facility account for 24.2% of all discharges home from a skilled nursing facility, which leads to increased mortality rates and poor patient outcomes. Much research has been conducted using the readiness for hospital discharge scale for patients discharging from a hospital setting to home to reduce 30-day hospital readmissions. However, no such research exists for using this scale to determine patient readiness to discharge home from a short stay at a skilled nursing facility. The main purpose of this dissertation study was to determine the reliability and validity of the adult medical-surgical long form of the readiness for hospital discharge scale (RHDS) to measure patient readiness in the geriatric population to discharge home from a short stay at a skilled nursing facility. The other purpose of this dissertation study was to determine whether patient readiness to discharge home predicts 30-day hospital readmissions for these same patients and which subscale of the readiness for hospital discharge scale is the best predictor of 30-day hospital readmissions. A total of 30 participants were conveniently and purposefully selected from six different skilled nursing facilities in Kansas City and Topeka with an additional four skilled nursing facilities in Wichita, KS on the day that they discharged home. A prospective study was performed with the reliability of the scale being determined by using Cronbach’s alpha. A binary logistic regression analysis was also utilized to determine the predictive validity of the study as to whether patient readiness to discharge from a short stay at a SNF predicts 30-day hospital readmissions. The principal investigator also used a binary logistic regression analysis to determine which subscale of the readiness for hospital discharge scale was most predictive of 30-day hospital readmissions in the geriatric population. All data was tested at the .10 level of significance, and the principal investigator used SPSS statistical software, version 28. The investigator concluded that the RHDS was a reliable measure in the skilled nursing facility setting as the Cronbach’s alpha was .917. The investigator also concluded that the RHDS was not a valid scale to predict hospital readmissions in patients over the age of 65 in a short-stay skilled nursing facility when completed by participants with a small sample size. The covariables for gender and education level were also assessed and were determined to be more predictive of hospital readmissions when compared to RHDS scores. The subscale of the questionnaire that was the best predictor of hospital readmissions was the personal status subscale. Keywords: reliability, validity, readiness for hospital discharge scale, skilled nursing facility, short stay, prospective study, hospital readmissions.

Disciplines

Medicine and Health Sciences

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