Purpose
The purpose of this assignment is to write the first parts of the DNP Project. This assignment will allow you to present the project’s purpose with objectives and the problem statement with significance from a global, national, and local/site perspective. This section includes the prevalence of the problem, the healthcare costs, and a description of the organizational need and practice gap related to the problem.
Instructions
Download the DNP Project Template from the Project & Practicum section of the DNP Program Resources page.
Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.
- The DNP Project Part 1 will be graded on the quality of information, use of current statistics and research, Standard English usage and mechanics, APA format, and overall organization based on the required components as summarized in the guidelines and grading criteria/rubric.
- Review the grading rubric carefully and consider how to incorporate each required criterion into Part 1 of the DNP Project Template.
- Review the tutorial on the use of the DNP Project Template in this week’s lesson.
Follow the instructions on the template for the purpose, problem, and problem significance. Submit Part 1 of the DNP Project.
- Title
Bold the title: Implementation of Project Re-Engineered Discharge (RED) to Impact 30-day Readmissions for Heart Failure Patients
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- The title should inform and engage the reader.
- The title can include your population, intervention, and/or anticipated outcome.
- The title should be concise and contain fully spelled out words with no abbreviations.
- Problem:
- Articulate the issue clearly and succinctly and its significance (incidence, prevalence, and/or mortality data) from a global, national, and local perspective. Then, conclude by discussing the problem within the practicum site. (3 paragraphs)
- Examine the global or worldwide prevalence, healthcare costs, and impact (mortality and/or other data) of the problem.
- Examine the global impact on nurses, quality of care, healthcare organizations, safety, society and/or social justice considerations as relevant to the project problem.
- Describe the national prevalence, healthcare costs, and impact (mortality and/or other data) of the problem.
- Analyze the national impact on nurses, quality of care, healthcare organizations, safety, society and/or social justice consideration as relevant to the project problem.
- Explain the problem at the practicum site. (If available and applicable, examine the incidence, prevalence, and financial impact.)
- Examine the practicum site impact on nurses, quality of care, safety, social justice, and the healthcare organization.
- Describe what the practicum site has done to address the problem, or state that there is no evidence that the problem has been addressed.
Heart failure (HF) is a complex clinical syndrome characterized by the reduced ability of the heart to pump and/or fill with blood. Despite the significant advances in therapies and prevention, mortality and morbidity are still high and quality of life poor. Nearly 1 in 4 heart failure (HF) patients are readmitted within 30-days of discharge and approximately half are readmitted within 6 months (Virani et al., 2020). It is estimated that approximately a quarter of HF readmissions are preventable with care management support (Virani et al., 2020). The evidence-based intervention for this proposed DNP project is the implementation of Project Re-Engineered Discharge (RED) to impact 30-day readmissions for HF patients. Project RED has 12 components that can be implemented; however, for the purposes of this project, the cardiology clinic team will be focusing on the care management components that include: (a) making appointments for follow-up care; (b) reviewing medications; (c) reconciling the discharge plan with national guidelines; (d) providing education to the patient; (e) reviewing signs/symptoms of exacerbation, when to report to the emergency room, and when to contact the clinic; (f) continual assessment of understanding of the instructions and education given; and (g) telephone follow-up reinforcement (AHRQ, 2020).
Heart failure (HF) has been defined as global pandemic, since it affects around 26 million people worldwide and in 2012, HF was responsible for an estimated health expenditure of around $31 billion worldwide, equivalent to more than 10 % of the total health expenditure for cardiovascular diseases in the United States (US) (Savarese & Lund, 2017). By 2030, it is projected that healthcare expenditures related to HF will increase by over 127% (Savarese & Lund, 2017). Heart failure (HF) has been defined as global pandemic, since it affects around 26 million people worldwide and in 2012, HF was responsible for an estimated health expenditure of around $31 billion worldwide, equivalent to more than 10 % of the total health expenditure for cardiovascular diseases in the United States (US) (Savarese & Lund, 2017). By 2030, it is projected that healthcare expenditures related to HF will increase by over 127% (Savarese & Lund, 2017). Heart failure (HF) has been defined as global pandemic, since it affects around 26 million people worldwide and in 2012, HF was responsible for an estimated health expenditure of around $31 billion worldwide, equivalent to more than 10 % of the total health expenditure for cardiovascular diseases in the United States (US) (Savarese & Lund, 2017). By 2030, it is projected that healthcare expenditures related to HF will increase by over 127% (Savarese & Lund, 2017). Studies indicate an increase in heart disease in both males and females; in fact, cardiac events have been found to occur in both sexes before the age of 65, leading to a decreased ability to work and quality of life (Savarese & Lund, 2017). In 2012, the Centers for Medicare and Medicaid Services (CMS) began supporting a program to improve healthcare quality by linking reimbursement to hospital care (CMS, 2021). This action reduced rates of reimbursement to those facilities with a high rate of readmissions related to six chronic medical conditions and procedures: (a) acute myocardial infarction, (b) chronic obstructive pulmonary disease, (c) heart failure, (d) pneumonia, (e) coronary artery bypass graft surgery, and (f) elective lower extremity total joint arthroplasties (CMS, 2021). Excessive readmissions associated with these six diseases can lead to a penalty of up to 3% of base reimbursed Medicare and Medicaid payments, causing a financial downfall for the organization (CMS, 2021).
- Project Aim and Supporting Objectives
- Explain the specific overall aim of the project.
- Identify 3-4 measurable objectives of the project that support the aim.
- Place the objectives in a sequenced format (a)…, (b)…., (c)…., etc.
This DNP project aims to prevent readmission of Heart failure (HF) patients after discharge. The objectives are to create a compliance checklist to track compliance with the interventions, conduct formative evaluation through daily morning huddles with staff to remind them of the project’s goals, and conduct random observations of staff delivering the interventions over the phone.
- References
- Information in this project must be substantiated by citations from current peer-reviewed journals (within the last 5 years).
- For the statistical data about incidence, prevalence, and mortality, you may use research and non-research such as government websites and credible national and global organizations such as CDC, AHRQ, World Health Organization, Kaiser Family Foundation, and Robert Wood Johnson. (See resources in the Week 2 Student Lesson Plan.)
- In-text citations should align with the reference page.
- In-text citations and references must be in the current APA format.
My References:
Agency for Healthcare Research and Quality. (2020). Re-Engineered discharge (RED) toolkit. Patient safety. https://www.ahrq.gov/patient-safety/settings/hospital/red/toolkit/index.html
Alvarez, P., Sianis, A., Brown, J., Ali, A., & Briasoulis, A. (2021). Chronic disease management in heart failure: Focus on telemedicine and remote monitoring. Reviews in Cardiovascular Medicine, 22(2), 403. https://doi.org/10.31083/j.rcm2202046
Centers for Medicare and Medicaid Services. Readmissions Reduction Program. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.html. Accessed 17 June 2022.
Khan, M.S., Sreenivasan, J., Lateef, N., Abougergi, M.S., Greene, S.J., Ahmad, T., Anker, S.D., Fonarow, G.C., & Butler, J. (2021). Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circulation: Heart Failure, 14(4), 450-457. https://doi.org/10.1161/CIRCHEARTFAILURE.121.008335
Patel, P. H., & Dickerson, K. W. (2018). Impact of the Implementation of Project Re-Engineered Discharge for Heart Failure patients at a Veterans Affairs Hospital at the Central Arkansas Veterans Healthcare System. Hospital pharmacy, 53(4), 266–271. https://doi.org/10.1177/0018578717749925
Psotka, M.A., Fonarow, G.C., Allen, L.A., Joynt Maddox, K.E., Fiuzat, M., Heidenreich, P., Hernandez, A.F., Konstam, M.A., Yancy, C.W., & O’Connor, C.M. (2020). The hospital readmissions reduction program: nationwide perspectives and recommendations: a JACC: heart failure position paper. JACC Heart Fail.,8, 1–11. doi: 10.1016/j.jchf.2019.07.012
Savarese, G., & Lund, L. H. (2017). Global Public Health Burden of Heart Failure. Cardiac failure review, 3(1), 7–11. https://doi.org/10.15420/cfr.2016:25:2
Virani, S.S., Alonso, A., Benjamin, E.J., Bittencourt, M.S., Callaway, C.W., Carson, A.P., Chamberlain, A.M., Chang, A.R., Cheng, S., Delling, F.N., et al. (2020). American heart association council on epidemiology and prevention statistics committee and stroke statistics subcommittee. heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 141, e139–e596. doi: 10.1161/CIR.0000000000000757. Epub 2020 Jan 29.
Wasfy, J.H., Zigler, C.M., Choirat, C., Wang, Y., Dominici, F., & Yeh, R.W. (2017). Readmission rates after passage of the hospital readmissions reduction program: a pre-post analysis. Ann Intern Med.,166, 324–331. doi: 10.7326/M16-0185
Wood, R. L., Migliore, L. A., Nasshan, S. J., Mirghani, S. R., & Contasti, A. C. (2018). Confronting challenges in reducing heart failure 30‐day readmissions: Lessons learned with implications for evidence‐based practice. Worldviews on Evidence-Based Nursing, 16(1), 43–50. https://doi.org/10.1111/wvn.12336
5. Create John Hopkins Tool. This form is used to document the results of evidence appraisal in preparation for evidence synthesis. The form provides the EBP team with documentation of the sources of evidence used, the year the evidence was published or otherwise communicated, the information gathered from each evidence source that helps the team answer the EBP question, and the level and quality of each source of evidence. Use 5-articles.
(See attached instructions)
6.Scholarly Writing Criteria
- Submit the paper on the DNP Project Template.
- Use the headers in the template.
- Use the current APA style and format throughout the manuscript.
- Use the Guidelines for Writing a Professional Paper (located in Student Resources) to complete this assignment.
- Turn on Grammarly to check the grammar, sentence structure, and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before construction of the assignment.)
Writing Requirements (APA format)
- Length: 2-3 pages (not including title page or references page)
- 1-inch margins
- Double-spaced pages
- 12-point Times New Roman font or 11-point Arial
- Headings & subheadings
- In-text citations
- Title page
- References page (without permalinks)
- Standard English usage and mechanics
- Organized presentation of ideas
Course Outcomes
This assignment enables the student to meet the following course outcomes:
- Synthesize scientific knowledge, theory, and practice expertise to inform evidence-based practice and impact outcomes. (POs 1, 3, 4, 5, 6, 9)
- Design an evidence-based translational science project to address a practice problem. (POs 1, 2, 3, 4, 5, 6, 7, 8, 9)
- Apply effective strategies in project design for managing practice problems in healthcare delivery at the micro, meso, and macro-system levels. (POs 1, 2, 3, 4, 5, 6, 7, 8, 9)
- Demonstrate project management and leadership skills in the design process for the evidence-based translational science project. (POs 1, 2, 5, 6, 7, 8, 9)
- Create collaborative relationships with interprofessional and intraprofessional groups to champion organizational improvements through project design. (POs 2, 4, 6, 8)
Rubric
Assignment Grading Rubric
| Assignment Grading Rubric | ||
| Criteria | Ratings | Pts |
| This criterion is linked to a Learning Outcome Title Requirements: 1. Bold the title. 2. The title should inform and engage the reader. 3. The title can include your population, intervention, and/or anticipated outcome. 4. The title should be concise and contain fully spelled out words with no abbreviations. | 5 pts Includes all requirements and creates an excellent title page. 4 pts Includes all requirements and creates a sufficient title page. 3 pts Includes fewer than all requirements and/or creates a basic title page. 0 pts Includes fewer than all requirements and/or provides an undeveloped title page. | 5 pts |
| This criterion is linked to a Learning Outcome Problem Requirements: 1. Articulate the issue clearly and succinctly and its significance (incidence, prevalence, and/or mortality data) from a global, national, and local perspective. Then, conclude by discussing the problem within the practicum site. (3 paragraphs) 2. Examine the global or worldwide prevalence, healthcare costs, and impact (mortality and/or other data) of the problem. 3. Examine the global impact on nurses, quality of care, healthcare organizations, safety, society and/or social justice considerations as relevant to the project problem. 4. Describe the national prevalence, healthcare costs, and impact (mortality and/or other data) of the problem. 5. Analyze the national impact on nurses, quality of care, healthcare organizations, safety, society and/or social justice consideration as relevant to the project problem. 6. Explain the problem at the practicum site. (If available and applicable, examine the incidence, prevalence, and financial impact.) 7. Examine the practicum site impact on nurses, quality of care, safety, social justice, and the healthcare organization. 8. Describe what the practicum site has done to address the problem, or state that there is no evidence that the problem has been addressed. | 50 pts Includes all requirements and provides an in-depth discussion about the problem. 46 pts Includes all requirements and provides a sufficient discussion about the problem. 42 pts Includes fewer than all requirements and/or provides a partial discussion about the practice problem. 0 pts Includes fewer than all requirements and/or provides an undeveloped discussion about the problem. | 50 pts |
| This criterion is linked to a Learning Outcome Project Aim and Supporting Objectives Requirements: 1. Explain the specific overall aim of the project. 2. Identify 3-4 measurable objectives of the project that support the aim. 3. Place the objectives in a sequenced format (a)…, (b)…., (c)…., etc. | 20 pts Includes all requirements and provides an excellent discussion of the aim and supporting objectives. 18 pts Includes all requirements and provides a very good discussion of the aim and supporting objectives. 16 pts Includes fewer than all requirements and/or provides a basic discussion of the aim and supporting objectives. 0 pts Includes fewer than all requirements and/or provides a poor discussion of the aim and supporting objectives. | 20 pts |
| This criterion is linked to a Learning Outcome References Requirements: 1. Reference publication dates must be within the last 5 years. 2. References must be from peer-reviewed journals, government websites, and/or credible national and global organizations related to the problem. 3. In-text citations should align with the reference page. 4. In-text citations and references must be in the current APA format. | 10 pts Includes all requirements and provides an excellent reference section. 9 pts Includes all requirements and provides a sufficient reference section. 8 pts Includes fewer than all requirements and/or provides a partial reference section. 0 pts Includes fewer than all requirements and/or provides an undeveloped reference section. | 10 pts |
| This criterion is linked to a Learning Outcome Scholarly Writing Criteria Requirements: 1. Submit the paper on the DNP Project Template 2. Use the headers in the template. 3. Use the current APA style and format throughout the paper. 4. Paper length is 2-3 pages. | 10 pts Includes all requirements and provides in-depth scholarly writing. 9 pts Includes all requirements and provides sufficient scholarly writing. 8 pts Includes fewer than all requirements and/or provides a basic scholarly writing. 0 pts Includes fewer than all requirements of APA style and standards and/or provides undeveloped scholarly writing. | 10 pts |
| This criterion is linked to a Learning Outcome Clarity of Writing Requirements: 1. Standard English usage and mechanics 2. No spelling or typographical errors 3. Organized presentation of ideas | 5 pts Includes all requirements and demonstrates excellent clarity of writing. 4 pts Includes all requirements and demonstrates sufficient clarity of writing. 3 pts Includes fewer than all requirements and/or demonstrates basic clarity of writing. 0 pts Includes fewer than all requirements and/or demonstrates poor clarity of writing. | 5 pts |
| Total Points: 100 |
