Date of this Version

2023

Document Type

DNP Project

Abstract

Background: Readmissions in healthcare are tied to higher mortality rates and are prevalent, reflecting the need for comprehensive strategies that focus on preventative measures and seamless post-discharge support to break the cycle of readmission and ultimately improve overall patient well-being. To prevent skilled nursing facility (SNF) resident rehospitalizations, improved communication and awareness of deteriorating conditions in SNF residents are crucial. The purpose of this project was to assess impact of an evidence-based educational program for SNF nursing staff focused on using telehealth to reduce resident rehospitalizations.

Methods: The QI project utilized a pre-post design to evaluate a SNF’s educational program. Telehealth usage data was provided by the director of the telehealth program 1 month before the educational program and 1 month after the program. A survey was developed and administered following the education program to assess nurses’ knowledge, attitudes, confidence, and barriers to using telehealth.

Result: Eighteen out of 30 eligible nurses (60%) participated in the DNP project. Most participants were registered nurses (n = 10, 55.6%), and 44.4% (n = 8) were licensed practical nurses. The majority (n = 16, 88.9%) were women between the ages of 18 and 60.

Survey: After the educational program all (n = 18, 100%) participants reported they knew where to locate telehealth equipment, and all reported an increased likelihood of using the telehealth program in caring for residents. The majority (n = 17, 94.4%) expressed confidence in using telehealth technology effectively to assess residents' conditions. The participants identified barriers to using the Telehealth Program, which included time constraints, lack of technical expertise, concerns about its usefulness, and equipment malfunctions.

Use of Telehealth: There was no use of telehealth 1 month prior to the educational program compared to two telehealth calls in the month following the program.

Conclusions: Nurse participants see telehealth positively, yet barriers to adoption exist. Following the educational program there was an increase in telehealth, although, the usage remains minimal. Future QI initiatives should consider the role local champions can play in sustaining quality improvement initiatives in the SNF.

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