One in four clients discharged from an acute care facility to a skilled nursing\nfacility (SNF) required readmission to the hospital within 30 days. Neuman,\nWirtalla & Werner believe that two-third of those readmissions are avoidable.\nReducing the frequency of rehospitalization from short-stay care is essential\nfor two primary reasons: 1) Clients are exposed to hospital-acquired infections\nthat lead to increased comorbidities, and 2) potentially avoidable hospitalization\nwill decrease the amount of funding distributed by Medicare. The\nsetting for the proposed change initiative was a for-profit, nondenominational\nSNF in Missouri. Of the 120 beds, 16 were devoted to short-stay care. The\nconvenience sample included four registered nurses and eight licensed practical\nnurses who had agreed to participate in the pilot. The purposive sample\nincluded short-stay clients. Interventions implemented at the pilot skilled\nnursing facility are components of the validated INTERACT quality improvement\nprogram. INTERACT (Appendix A) is comprised of several tools\ndesigned to assist and guide front-line staff in early identification, assessment,\ncommunication, and documentation about acute changes in client condition.\nMeasured results examined the effectiveness of the proposed intervention.\nThe outcome being assessed in the project was the number of avoidable hospital\nadmissions after implementation of the INTERACT quality initiative\ntools. The long-term objective for the pilot was a 2% decrease in client rehospitalizations\nfrom the short-care unit during the eight weeks of practice implementation.\nThe clinical question for the proposed practicum project was,\nâ??For the nursing staff on a short-term rehab unit, does the implementation of\nan evidence-based patient evaluation tool, INTERACT lead to a reduction in\navoidable hospital admissions?â?.
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