Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Patricia A. Schweickert

Abstract

Chronic obstructive pulmonary disease (COPD) is a collection of chronic conditions that results in irreparable lung damage and stress to patients. COPD also has considerable financial impacts on health care entities due to frequent hospital readmissions of COPD patients. The Centers for Medicare and Medicaid Services penalize care entities for 30-day hospital readmissions. Many rehospitalizations attributed to COPD are due to exacerbations, often preceded by physiologic and emotional changes that can be monitored, allowing action to be taken to prevent readmissions. The practice problem for this quality improvement project explored whether the use of remote home monitoring of COPD patients discharged to home health care, coupled with the use of a medication rescue pack, would reduce rehospitalizations within 30 days after discharge. The purpose of the project was to evaluate the effectiveness of telehealth remote monitoring and initiation of a medication rescue pack in decreasing 30-day readmissions of COPD patients. The self-efficacy model was used to encourage health-promoting actions that are necessary for chronic disease management. Data from the project agency's records of COPD patients were evaluated for readmission rates. Analysis of the data from 8 preintervention patients showed that 3 (38%) were readmitted. Postintervention data showed that of the 9 participants, only 1 was readmitted (11%). Comparison of the data showed a 27% decrease in readmissions because of the intervention. The results of this project have the potential to bring about positive social change by improving care management remotely in real time, thus decreasing rehospitalization in COPD patients.

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