Too many people are discharged from hospitals before they are ready and have to return — often within 30 days. There are many reasons for this trend, including the hospital’s policy as well as the patient’s choice. But the “revolving-door” predicament is expensive. Many of those who are readmitted are Medicare patients, and since the federal government pays for Medicare, taxpayers foot the bill.
Registered nurses (RNs) and nurses with a Bachelor of Science in Nursing (BSNs) are well prepared to help these patients while playing an important role in reducing hospital readmission rates.
Causes of Hospital Readmission
Readmission rates vary across the country, and there does not seem to be a single cause or indicator.
Readmissions can be bad for patients for many reasons. Patients often leave the hospital without their illness or injury fully under control. Another reason patients return is that they have no one to help care for them at home. For instance, the family may be unwilling or unable to provide adequate care. Some patients do not understand discharge instructions, and they fail to take the correct steps once they return home. Chronic illness is also a major cause of readmissions.
In order to keep costs down, hospitals are under a great deal of pressure to keep patient stays short. Hospitals pay a larger portion of the costs if patients stay longer than the allotted time the insurance company will pay for.
Nurses understand that readmissions can be dangerous, especially for the elderly and those suffering from chronic conditions. The risk of infection poses a challenge to these patient groups in hospitals.
Nurses Make a Difference
The online RN to BSN program can prepare nurses to help reduce hospital readmission rate for patients. According to a recent paper published in Medical Care, “Nurses are the frontline for providing many of the core processes of care aimed at preventing readmissions — knowledge assessment, patient education, discharge preparation and care coordination.”
The nurse’s work environment is the ideal place to take specific action. Discharge instructions, for example, are important. People might not understand instructions. A patient might be taking medications that interfere with ability to understand information. A hospital is also an unfamiliar environment, and that might cause confusion as well. As a nurse, you will assess your patient’s ability to understand discharge instructions and take a leadership role in determining the best way to instruct patients.
Reducing Readmission Rates
The nurse’s work environment includes an interdisciplinary team of professionals. Dietitians, social workers and physicians create the best outcome for the patient. These professionals are well aware of the problem of readmissions. The team can often create discharge plans almost as soon as a patient is admitted. The earlier the patient understands discharge instructions, the better. The nurse can determine what the patient understands about care at home after discharge.
Nurses are trained to identify when patients may have challenges meeting certain discharge instructions. Patients may be too embarrassed to explain that there is no one at home to help. Or they may not have enough money to afford good nutrition. Running errands could be a problem, or they may not be able to afford their medicine. Your education will prepare you to understand how best to treat the patient who does not wish to disclose critical information.
Problems and Solutions
The readmission of patients to hospitals within 30 days is a problem for hospitals and patients alike. The reasons for readmissions vary depending on the region and the patient. A team of healthcare professionals in the hospital can address this problem by creating a plan for the best outcomes for patients being discharged.
As a nurse, you will be the first to understand that your patient is high-risk. One way to help is by requesting social work/case management support before discharge plans are final. Nurses are in an ideal position to educate patients and families, and to help reduce hospital readmission rates.
Learn more about the Purdue Northwest online RN to BSN program.
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