Date of Conferral



Doctor of Nursing Practice (DNP)




Dr. Catherine Garner


Hospital readmissions are disruptive and costly for patients and hospitals. As hospital discharge instructions are a key nursing responsibility, this project implemented a nurse follow-up phone call intervention within 12â??48 hours of patient discharge from an indigent care facility in the Great Lakes region of the United States. The project was designed to understand whether follow-up phone calls from nurses that clarified discharge instructions, symptom management, and medications would be associated with decreased readmission rates within 30 days post-discharge among chronic care patients. The theoretical framework was the health belief model, which proposes that the patient's knowledge of illness severity, susceptibility, and benefits of care predicts his/her health-related behaviors, including self-care. A comparison of the hospital readmission rate prior to 30 days of discharge in the baseline (pretest) group was 77.87%, and 22% in the Post-intervention group within the same facility. Chi-square results showed a significant association between the follow-up calls and decreased hospital 30-day readmission rates, X2(1) = 6.605, p = 0.010, This low-cost intervention can and should be replicated in other indigent care hospital facilities. Similar results may suggest a causal relationship that can later be explored in large scale research studies. This study may contribute to social change by demonstrating a practice that provides reduction in 30-day patient readmissions, which benefits patients' and families', economic and health outcomes.

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