NURS-FPX 6030 MSN Practicum and Capstone ​​​​​​​Final Project Submission

Abstract

The capstone project aimed to improve patient understanding of post-discharge regimens, reduce hospital readmissions, and enhance patient satisfaction following cardiac catheterization by implementing a tailored educational program and integrating telehealth services. The initiative sought to address knowledge gaps and continuity of care for post-cardiac catheterization patients, ensuring they receive adequate information and support after discharge. The approach involved individualized discharge education and the use of multimodal education delivery, including audiovisual aids and remote monitoring devices, to disseminate information and address concerns. Key findings included the potential for nurses to act as key knowledge brokers, enhancing patient care, and the indication that well-informed patients have reduced readmission rates, potentially saving healthcare costs.

Introduction

This capstone project addresses the high 30-day hospital readmission rates among patients with Coronary Artery Disease (CAD) discharged after cardiac catheterization at Manatee Memorial Hospital in Bradenton, Florida. The focus is on enhancing post-discharge patient education to improve outcomes. The intervention plan aims to strengthen post-discharge outcomes through comprehensive and individualized discharge education, integrating telehealth services. This intervention is supported by evidence highlighting the effectiveness of tailored discharge education and modern telehealth technologies in improving postoperative outcomes and patient satisfaction.

Problem Statement

Need Statement

This study aims to compare the impact of implementing a comprehensive and personalized post-discharge education program versus providing basic discharge instructions on 30-day hospital readmission rates and patient outcomes among patients discharged from Manatee Memorial Hospital after cardiac catheterization. According to a study by Madan et al. (2019), 30 percent of patients discharged after percutaneous coronary intervention (PCI) were readmitted within 30 days, emphasizing the urgency to minimize readmission rates to improve health outcomes and reduce healthcare costs.

Population and Setting

The target population consists of patients discharged after cardiac catheterization, who are at increased risk of post-discharge complications. Addressing this population’s needs is crucial to reduce complications, decrease readmission rates, and improve patient satisfaction. The intervention is implemented at Manatee Memorial Hospital, where readmission rates among cardiac catheterization patients are significantly higher than the national average, indicating the need for comprehensive and personalized education.

Intervention Overview

The intervention comprises tailored discharge education and telehealth services to reduce readmission rates among cardiac catheterization patients. The Plan-Do-Check-Act (PDCA) cycle was applied to develop an individualized post-cardiac catheterization education program. This involved identifying factors contributing to readmissions, creating customized education programs, collecting feedback, and continuously monitoring outcomes. Challenges such as healthcare illiteracy and language barriers among Manatee County residents were considered during implementation.

Comparison of Approaches

Inter-professional collaboration is crucial for delivering comprehensive care to post-cardiac catheterization patients. While customized education plans are effective, alternative strategies such as standardized education plans and group education sessions led by inter-professional teams can also address patient needs.

Initial Outcome Draft

The goal is to reduce 30-day readmission rates by 20%, increase medication adherence by 15%, increase follow-up appointment attendance by 30%, and improve symptom reporting by 25% within 12 months.

Time Estimate

The estimated timeframe for developing and implementing the education program is approximately 12 months, including planning, platform development, pilot testing, full-scale implementation, and ongoing monitoring.

Literature Review

Comprehensive education post-cardiac catheterization has shown to reduce cardiac arrest incidents and improve medication adherence, leading to fewer readmissions. Tailored education interventions have been effective in reducing readmission rates, emphasizing the importance of personalized education. Telehealth policies support continuous education and care, benefiting remotely located patients and allowing for timely interventions, thereby reducing readmission rates.

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