Date of Conferral



Doctor of Nursing Practice (DNP)




Robert McWhirt


The health care system has focused on reducing costs associated with longer lengths of

stay while facilitating safe and appropriate discharges. The purpose of this educational

project was to increase awareness among health care providers regarding nudging and

how it influences discharge planning decisions by patients and families. Enhancing health

care providers’ understanding of the impact of discharge communication may address the

issue of alternate level of care (ALC). Transition theory was used to frame the project.

Practice-focused questions addressed how the use of evidence-based case studies about

nudging could improve discharge planning for patients in a large community hospital in

Ontario, Canada, and the impact that nudging has on the ALC rate 3 months

postimplementation. The project focused on enabling staff to self-identify instances of

nudging, strategies, and messaging techniques to use during conversations about

discharge planning. Of 48 nursing staff available, 22 participated in at least one of the

three educational modules. Descriptive data showed that staff increased their awareness

of nudging and developed new strategies to adapt their practice. Concurrent projects in

the hospital to reduce the number of ALC patients in the organization may decrease the

ALC rate. Through enhanced patterns of response, nurses promote positive social change

by helping patients and families feel more confident in their decisions related to

discharge and reducing overall cost to both the patient and the health care system.

Included in

Nursing Commons