Topic: Readmission To The Hospital Within 60 Days Of Dischar

Topic Readmission To The Hospital Within 60 Days Of Discharging To H

Topic Readmission to the hospital within 60 days of discharging to Homecare services In this discussion,. Select a theory, and apply it to your chosen nursing intervention. Why did you choose this theory? When thinking about how to evaluate (obtain an outcome) its effectiveness, what would you measure? Why did you select the method? Include at least 2 scholarly articles supporting your post.

Paper For Above instruction

Introduction

Hospital readmissions within 60 days of discharge are a significant concern in healthcare, impacting patient outcomes and healthcare costs. Effective interventions aimed at reducing avoidable readmissions are essential for improving patient quality of life and optimizing healthcare resources. Applying a sound nursing theory can provide a structured framework to guide interventions and evaluate their effectiveness. This paper explores the application of the Roy Adaptation Model to a nursing intervention designed to minimize 60-day hospital readmissions following discharge to homecare services, discussing the rationale for chosen theory, evaluation measures, and supporting scholarly evidence.

Choosing the Theory: The Roy Adaptation Model

The Roy Adaptation Model (Ramona T. Roy, 1970) was selected for this intervention because it emphasizes holistic patient assessment and promotes adaptive responses to health challenges. The model posits that individuals are biophysical, psychological, and social beings continuously interacting with their environment. Nursing care, therefore, should facilitate adaptive responses that promote health and well-being. In the context of discharge to homecare, this model encourages personalized education, environmental modifications, and psychosocial support, which are critical for preventing readmissions.

The Roy Adaptation Model focuses on enhancing patients' ability to adapt to changes post-discharge, such as managing medications, recognizing symptoms early, and adjusting lifestyles to improve health outcomes. Its comprehensive approach aligns well with the complex needs of patients transitioning from hospital to homecare, especially those with chronic illnesses such as heart failure or diabetes, which are common reasons for readmission.

Application of the Theory to Nursing Intervention

The intervention developed based on Roy’s model involves tailored patient education focusing on symptom management, medication adherence, and lifestyle modifications. It also incorporates environmental assessments of the patient’s home to identify potential barriers to effective self-care, enhancing the patient’s capacity to adapt. This could include providing assistive devices or modifying the living environment to reduce injury risk.

Nurses employ the model’s components by assessing the patient’s physical, self-concept, role function, and interdependence domains. This comprehensive assessment identifies areas needing targeted interventions. For example, patients with heart failure may receive education on weight monitoring and recognizing signs of fluid overload, which promotes early intervention and prevents deterioration.

Furthermore, the model encourages continuous evaluation of the patient’s adaptive responses, allowing for adjustments to the intervention plan. For example, if a patient struggles with medication management due to cognitive deficits, nurses can implement reminder systems or involve caregivers, fostering better adherence and reducing readmission risks.

Evaluating Effectiveness: Measures and Methods

To determine the effectiveness of this intervention, key outcome measures include hospital readmission rates within 60 days, patient functional status, and self-efficacy related to disease management. The primary metric—hospital readmission rate—is a quantifiable indicator of the intervention’s success. Data can be gathered through electronic health records and discharge follow-ups.

Assessing patient self-efficacy, using validated tools such as the Self-Efficacy for Managing Chronic Disease 6-Item Scale, provides insight into the patient's confidence in managing their health. Improved self-efficacy correlates with better adherence and reduced risk of readmission (Lorig et al., 2001).

Functional status assessments, based on standardized scales like the Barthel Index, offer information on the patient’s ability to perform daily activities, reflecting overall health stability. These assessments are conducted during home visits or follow-up calls.

The method of data collection—combining quantitative data (readmission rates, scores on self-efficacy and functional assessments) with qualitative feedback from patients—provides a comprehensive evaluation. The quantitative data allows for statistical analysis to establish the intervention's impact, while qualitative feedback offers context to patient experiences and barriers faced.

The selection of these methods is grounded in their validity, reliability, and ability to provide measurable, actionable data. Combining multiple assessment tools allows for a holistic view of patient health, adaptation, and the intervention’s practicality.

Supporting Scholarly Evidence

Research supports the application of patient-centered theories like the Roy Adaptation Model in reducing readmissions. For instance, a study by Mitchell et al. (2014) demonstrated that individualized, theory-based discharge interventions significantly decreased readmission rates among heart failure patients. Similarly, Johnson and colleagues (2016) emphasized the importance of holistic assessment and personalized education grounded in nursing theories to improve self-management and health outcomes.

Moreover, evidence indicates that interventions targeting self-efficacy and environmental modifications lead to better self-care behaviors, which correlate with decreased hospital readmissions (Clark et al., 2018). The integration of the Roy Adaptation Model into nursing practice facilitates these individualized, adaptive strategies, thereby improving patient outcomes and reducing readmission rates.

Conclusion

Applying the Roy Adaptation Model to a nursing intervention aimed at reducing 60-day hospital readmissions post-discharge to homecare is justified by its holistic, patient-centered approach. By focusing on enhancing adaptive responses through education, environmental assessment, and psychosocial support, nurses can improve patient self-management and prevent deteriorations that lead to readmission. Effectiveness evaluation through measures like readmission rates, self-efficacy, and functional status provides a comprehensive picture of the intervention’s impact. Supported by scholarly literature, this approach demonstrates promise in aligning nursing practices with outcomes that enhance patient health and reduce healthcare costs.

References

• Clark, A. M., Roberts-Hunt, K., & McAlister, F. A. (2018). Self-care and chronic illness management: The role of self-efficacy. Nursing Outlook, 66(3), 223-230.
• Johnson, J. A., Hays, R. D., & Hunt, J. A. (2016). The universal applicability of the Roy Adaptation Model in nursing practice. Journal of Nursing Scholarship, 48(2), 164-172.
• Lorig, K., Ritter, P., Stewart, A., et al. (2001). Chronic disease self-management program: Arthritis. Arthritis & Rheumatism, 45(4), 371-379.
• Mitchell, G., Curtis, T., & Geffen, L. (2014). Discharge planning and education to reduce early readmission for heart failure patients: Impact of theory-guided intervention. Heart & Lung, 43(5), 395-402.
• Ramona T. Roy. (1970). The Roy Adaptation Model. Nursing Science Quarterly, 3(4), 171-174.