RESUMO
BACKGROUND: Transitioning patients from the hospital to home after a total hip or knee arthroplasty is challenging. Severe pain, comorbidities and complex medication regimes have the potential to delay readiness for discharge, increase length of stay (LOS), and cause readmissions. OBJECTIVE: The goal of this practice improvement project was to improve patient readiness for discharge after total joint arthroplasty to reduce LOS, prevent emergency department (ED) visits, and prevent hospital readmissions. METHODS: This quality improvement project was guided by the Iowa Model and implemented a prepost program implementation evaluation design. Nurses incorporated the Registered Nurse Assessment of Readiness for Hospital Discharge Scale (RN-RHDS) to guide and evaluate discharge education efforts. RESULTS: The focused education cohort demonstrated significantly decreased LOS and decreased readmissions compared to the cohort receiving standard education efforts. ED visits were not significantly different amongst cohorts. CONCLUSION: This practice improvement project demonstrates successful translation of research into practice. IMPLICATIONS FOR NURSING: The use of focused education and the RN-RHDS tool is recommended for nursing to improve patient readiness for discharge and patient outcomes.
RESUMO
This study explored BSN students' perceptions of learning with vSim for Nursing™. Using a mixed methods design with 99 students, key points of learning were medication administration and respiratory interventions. Qualitative data demonstrated learning of assessment, prioritization, and emergency management. The top student preferences of how to use virtual simulation were as a clinical makeup or to enhance lecture. The findings support the use of virtual simulation and provide data to guide nurse educators to more strategically integrate virtual simulation exercises.
