Project Justification
Many studies on readmission focus on the discharge process and providing information and options accessible outside of the healthcare facility. Heart failure is a global public health threat that demands intensive analysis to formulate effective interventions (Lan et al., 2021). The crucial missing component, however, is a patient education program in which instruction begins before heart failure patients are hospitalized in the unit. It entails giving the patient the necessary resources, education, and information to facilitate learning and enhance their comprehension of specific health issues. In addition, it allows patients to participate in their treatment. Nurses are ideally situated to interact with and form partnerships with patients and their families to help them establish and maintain a healthy lifestyle while concentrating on vital aspects of their conditions.
Development and Implementation of Plan
This quality improvement initiative aims to create a nurse-led patient education intervention and provide organized training to unit nurses to increase their knowledge of heart failure. The interventions associated with the proposed patient education program include a nurse-led standardized heart failure discharge protocol and an assessment tool to measure the education learned by the nurses through a pre and post-test. It should be noted that chart audits will be performed to ensure protocol compliance and compare pre- and post-implementation readmissions.
Before application, the proposed nurse-led patient education intervention for individuals diagnosed with heart failure will be presented for approval. A PowerPoint presentation will be created to educate participants on how to apply the approach to minimize HF readmissions. The project leader will construct a pre-and post-test that will be implemented before and after the training session to check unit nurse knowledge. An audit tool will also be developed to check nurse compliance with discharge protocols, and data will be gathered to examine any heart failure readmission rates after the patient education program is implemented.
The proposed change assignment will take four weeks to complete. During the implementation phase, a pre-test will be performed shortly before the instruction session on utilizing and applying the patient education program. The instructional session will last 45 minutes after the pre-test. A post-test will be given immediately following the session to assess the knowledge gained. The instructional sessions will be held throughout the first week of the implementation period, with groups of 5 participants meeting for 45 minutes at a time. After completing the education, the program’s implementation will commence with all patients hospitalized with a diagnosis or a history of heart failure. The project leader will conduct a daily evaluation of the patient census to identify individuals admitted to the unit with a diagnosis or history of heart failure. It is vital to ensure that the nurses in the unit are implementing the project effectively. Data on re-admission rates will be collected during the project’s implementation to assess the program’s effectiveness.
Change Theory Framework and Its Relation to the Project
Kotter’s Eight Steps for Change will be used in the framework for the culture of change. The aim is to ensure that the project achieves an appreciable decrease in heart failure readmissions by the end of the year. The first of the eight-step process proposed by Kotter is the creation of urgency (Laig et al., 2021).
The gathering of data from the institution will be prioritized, and a needs assessment will be conducted. PowerPoint presentations will be created to demonstrate the need to implement unit changes. Meetings are a vital means through which the gathered data can be presented to win support. A comprehensive evaluation of the literature on alternative policies is critical.
The next step involves forming a resilient coalition team with the unit’s Assistance Nursing Manager (ANM), Care Team, Patients Care Coordinator (PCC), and Social Worker to ensure the project’s success. The third step involves the creation of a transformation route (Laig et al., 2021). The step requires parting with old habits and accepting new ideas, which can sometimes be challenging.A notice board is a vital tool that gives staff members a clear image of the change project. In addition, it defines the phases of the proposed patient discharge education intervention and the set deadlines.
The fourth phase of the change process entails explaining the project’s goal and providing regular updates (Laig et al., 2021). The fifth phase removes people and other potential impediments to progress (Laig et al., 2021). The program’s creators will constantly train, audit, and assist the unit personnel to implement quality and preventative strategies. It is worth noting that older staff have preferred methods of accomplishing tasks that they feel are effective, even when the data reveals otherwise. Therefore, it is essential to consider that change takes time and incentive.
The sixth stage of the change process prioritizes the recognition of short-term successes. Nurses will be complimented for embracing the transformation initiative, and each member will receive recognition badges for adjusting to the project’s aims. The project must continue to build on the small positive adjustments that have already been achieved in the seventh phase. The final phase of the initiative involves analyzing the project’s progress and reinforcing beneficial results.
Evaluation of Change Process
Descriptive analyses assess the effectiveness of teaching the cardiac zones in the patient education intervention. Team leaders are in charge of evaluating and supervising how unit nurses utilize the patient education intervention. The team leaders are expected to compile daily progress reports to assess the level of success.
In addition, they are expected to guide unit nurses and emphasize their orientation toward the project’s goals. A summary of the cardiac zones and lifestyle changes required in the context of heart disease is available for the nurses’ quick reference in the unit. The material will also be used for auditing purposes.
A paired-sample t-test will be used to assess the influence of nurses’ training in heart failure readmission and implementation of the patient education protocol. The T-test is used to contrast the means of two groups, and there is no need for numerous comparisons because a single P value is detected (Mishra et al., 2019). Identifying statistically significant changes in knowledge between the pre-and post-test will be important.
A simple binary logistic analysis will evaluate compliance with the patient education program. The model will contain an independent variable in the form of the patient education protocol and a dichotomous dependent variable divided into groups of ‘yes’ and ‘no’. The model will predict the degree of compliance necessary for the institution of change.
Finally, the association between patient readmission and the implementation of the patient education intervention will be analyzed using a Pearson product-moment correlation coefficient. It indicates the intensity and direction of association between two variables assessed on an interval scale (Okwonu et al., 2020). Identifying the correlation between the highlighted variables is necessary to determine whether or not the change initiative is effective.
References
Laig, R.B D., Ferdinand, T. & Abocejo F. T. (2021). Change management process in a mining company: Kotter’s 8-step change model. Journal of Management, Economics, and Industrial Organization, 5(3), 31-50. Web.
Lan, T., Liao, Y. H., Zhang, J., Yang, Z. P., Xu, G. S., Zhu, L., & Fan, D. M. (2021). Mortality and readmission rates after heart failure: A systematic review and meta-analysis. Therapeutics and Clinical Risk Management, 17, 1307–1320. Web.
Mishra, P., Singh, U., Pandey, C. M., Mishra, P., & Pandey, G. (2019). Application of student’s t-test, analysis of variance, and covariance. Annals of Cardiac Anaesthesia, 22(4), 411. Web.
Okwonu, Z. F., Laro Asaju, B., & Irimisose Arunaye, F. (2020). Breakdown analysis of Pearson Correlation Coefficient and robust correlation methods. IOP Conference Series: Materials Science and Engineering, 917(1), 1–9. Web.
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