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 12-48 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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