Document Type
DNP Project
Publication Date
9-24-2025
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Dr. Dorothea Esposito PhD(c), DNP MSN/ed, APRN, FNP-BC
Practice Mentor
Jincy Joseph, DNP, RN, NEWA-BC, CCRN
Abstract
Background
Hospital readmissions remain a critical challenge in healthcare, especially in medical-surgical units. The high rates of hospital readmissions are often linked to inadequate patient understanding of discharge instructions. Many patients struggle with deciphering discharge plans, leading to medication errors, missed follow-up appointments, and poor self-care management. A structured discharge teaching protocol has the potential to enhance patient comprehension, improve adherence to port-discharge care, and reduce readmission rates.
Project Goals
This project aimed to improve understanding of discharge instructions, reduce hospital readmissions, and enhance patient satisfaction with the discharge process. Specific objectives included increasing patient comprehension from 65% to 90% within 30 days post-discharge, reducing readmission rates by 20%, and achieving a 20% improvement in patient satisfaction scores within two months of implementation.
Methods
A structured discharge teaching protocol was implemented on a 33-bed medical-surgical unit to diminish the issue of excessive hospital readmission. The protocol included patient-specific education sessions and follow-up support, bolstered by the Johns Hopkins Evidence-Based Practice (JHNEBP) model and Plan-Do-Study-Act (PDSA) cycles. Effectiveness was determined using a pre-post intervention design. Post-implementation, patient comprehension was assessed using the AIDET Smart Tool and post-discharge questionnaires, while readmission rates were tracked using electronic health records.
Results
The structured discharge planning protocol demonstrated measurable improvements: patient understanding scores increased from 65% to 92%, surpassing the 90% goal. Thirty-day readmissions decreased by 22%, and patient satisfaction scores related to discharge education improved by 25%. The intervention also supported a reduction in average length of stay by 0.5 days, reflecting more efficient discharge processes.
Conclusion
The project underscores the importance of structured, patient-centered protocols in enhancing outcomes and reducing healthcare costs. Findings advocate for institutional adoption of similar frameworks to strengthen care transitions. Future efforts should focus on sustainability through staff education and the integration of technology.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Joseph, J. (2025). Enhancing patient understanding and reducing readmissions: Implementing a structured discharge teaching protocol in a medical-surgical unit [Unpublished DNP project]. Sacred Heart University. https://digitalcommons.sacredheart.edu/dnp_projects/98
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.