Date of this Version

12-2-2021

Document Type

DNP Project

Abstract

Hospital readmissions from skilled nursing facilities (SNF) are associated with increased resident morbidity, mortality, and healthcare costs. Identification of effective approaches to prevent unnecessary rehospitalizations is warranted. Telehealth has emerged as a viable approach for improving resident care in SNFs with the potential of reducing hospital readmissions. The purpose of this Doctor of Nursing Practice (DNP) project was to develop, implement, and evaluate the impact of a new evidence-based, educational program for the SNF nursing staff focused on the use of telehealth to prevent resident rehospitalizations. The web-based program provided knowledge about the optimal use of telehealth to enhance its adoption and included clinical vignettes. The program was evaluated by a survey, grounded in the transtheoretical model (Prochaska & DiClemente, 1979), and telehealth usage data. A pre-post design was used (repeated the same survey 2 weeks following the educational program). About one out of every four eligible SNF nurses participated in the program and completed the pre and post survey (N = 14, 27%). All participants were registered nurses (RNs) between the ages of 25 years old to 59 years old, 78.6% (n = 11) were women, 71.4% (n = 10) were nurse staff, and 28.6% (n = 4) were supervisors. The 10-item survey focused on knowledge and perceived confidence in nurse-initiated telehealth for resident care. There was a statistically significant improvement (p < .05) in both nurse telehealth knowledge and confidence observed. There was no observed change in telehealth use in the 2-month period following the educational program. The primary finding from this quality improvement (QI) project was that a brief, web-based educational program can increase nurses’ knowledge and confidence regarding the use of a telehealth program for SNF residents. Although there was no change in actual telehealth use, further education, facility support, and reminders should be considered.

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