Date of Conferral

2017

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Allison Terry

Abstract

Following implementation of the Patient Protection and Affordable Care Act, hospitals have seen a reduction in Medicare reimbursement for 30-day post-discharge readmissions of acute myocardial infarction patient. The purpose of this project was to develop a plan for a navigator program to improve a patient's health status post discharge and reduce readmission rates. The Johns Hopkins nursing evidence-based practice model and guidelines were used in determining the quality of obtained experimental and non-experimental studies with or without meta-analysis and popular source articles. The literature revealed the most successful programs involved providing best practices for a navigator program allowed better patient education, discharge planning, safety and quality of care, improved communication and post-discharge follow-up, and improved facility finances to achieve positive results for the patient and the hospital. Watson's caring theory was used as the theoretical framework since it incorporated the aspect of caring to create a good working nurse-patient relationship. A navigator program training module, job description, objectives, program forms, mission and goal statements, and a health care team were developed and seen as crucial to the success of the program and its evaluation process. Using navigator practices, based on evidence, formed the infrastructure and management process for the facility and health care providers, thereby increasing the quality of patient care. The resulting social change was positive, benefiting the patient, family, the organization, and the region served. With implementation, this project was anticipated to reduce 30-day readmissions and increased facility reimbursement.

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