Running head: REDUCING STROKE READMISSIONS 1

REDUCING STROKE READMISSIONS

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Michelle L Wallace

NUR 430

Professor Roberts

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format issues; the number one should be over to the right upper corner.

per APA, title page is not bolded

REDUCING STROKE READMISSIONS

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Cardiovascular diseases, obesity, cancer, and stroke are some of the leading diseases in

the world, and they are the most frequent causes of death in recent past years. Stroke is the

condition when there is a blockage of blood supply, and oxygen to any part of the brain. This

will cause the death of brain cells. This capstone project is about stroke readmissions that are

increasing with passing time. There are efforts being made to reduce stroke readmissions to

hospitals, and it involves a lot of factors. Patients should be given proper awareness, and nurses

should be educated so they may treat the patients with the appropriate care necessary. According

to the American Heart Association, 389 deaths occur each day due to a stroke in 2016 (Sunil,

2013). The ACE Star Model will be incorporated by discovering ways to reduce readmissions,

providing evidence-based studies, identifying the risk factors, and achieving positive outcomes

which would be the reduction of stroke readmissions. This proposal will discuss the different

ways to reduce the stroke causes and readmissions in the hospital.

The purpose of the project is to discuss the different causes of stroke and other

cardiovascular diseases and further, it will discuss the ways of prevention and treatment as well.

It is a common observation that stroke readmissions are increasing day by day, and patients are

not getting enough care and treatment in hospitals. It is observed that may stroke patients are

admitted to the hospital, go home after treatment; and unfortunately, have to re visit hospitals

again and again. The awareness level has to be increased and the education level has to be

enhanced as well. The community should be engaged in the different training sessions and

proper guidance

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should be given to them (Stephanie Rennke, 2015). There are different strategies for reducing

stroke readmissions in the hospitals. First, it should be noticed that the immune system and

nervous system of the patients are weak, and they have to build immunity and the concept of

self-care should be introduced. The families and peer groups should be supportive enough and

diet recommendations should be given to them. Subsequently, it would be the duty of the nurses

to provide education to patients hopefully resulting in the reduction of stroke readmissions.

Personal Reflections

There are different significant issues regarding ailments and medical experts are

presenting their strategies to control these issues; however, I have selected stroke for the

proposal. Stroke and its incidence are increasing day by day, and the western countries are most

at risk. Sedentary lifestyles are increasing, and the junk food prevalence is enhanced in western

countries as well. We as a people are so busy with jobs and business, there is very little time to

incorporate a healthy lifestyle. Unfortunately, there is a lack of routine exercise as a nation. On

the other hand, the ratio of smokers is also increasing, in which is a major contributor to stroke.

The awareness level has to be increased and nurses should be educated as well (Hefzy, 2017).

So, I am studying these risks to assist in finding a solution.

Activities

I have planned several steps and activities for reducing the stroke readmissions in the

hospitals. education level to the nurses and to increase the awareness level to the community.

The first step is to engage with the stroke coordinator for my facility. Fortunately, the stroke

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what are the other activities? Ongoing research to support this scholarly capstone?

coordinator is my preceptor. Together, we will attend the stroke alerts for the hospital. We will

also attend the stroke rounds with the inpatient rehab physician, and therapy. When doing this,

we

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will be able to see what resources the patients are lacking that may be causing the stroke. We

will then begin to provide information the patient will need to be successful. It is vital to be

aware of pertinent information such as family support. All of this data will better allow staff to

understand possible strategies to reduce stroke readmissions. This will also give the nurse the

proper avenue to take in providing education to his or her patient. The next step is to meet the

families and peer groups of the patients, as they will be involved in the care of the patient as

well. Together we will find out the triggers, and work as a unit to prevent further readmissions. It

is important to know what issues they feel will lead them back to hospital. Lastly, the final step

will convince the patients to modify their lifestyle and change their dietary intake. The dietary

intake will be increased in fruits, vegetables, and fiber and to reduce the extra fats and

cholesterol (Christina Condon, Sarah Lycan, & Pamela Duncan, 2015).

Outcomes: Planned

My planned outcomes are to show the decrease in stroke readmission in hospitals and

to increase the education level and training of nurses. The stroke prevalence will be reduced and

people will try to modify their lifestyle and will adopt a healthy diet to reduce the diseases. Some

of the literature is as follows. Clinics are tested with reconsidering their medical clinic’s

transitional consideration rehearses, to lessen 30-day readmission rates, forestall antagonistic

occasions, and guarantee protected progress of patients from emergency clinic to home.

Regardless of the expanding consideration regarding transitional consideration, there are hardly

any distributed investigations that have indicated huge decreases in readmission rates, especially

for patients with stroke and other neurologic findings.

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The fruitful emergency clinic started transitional consideration programs incorporate a

“connecting” system with both pre-discharge and post-discharge mediations and committed

advances supplier required at numerous focuses in time. In spite of the fact that multi-component

techniques including tolerant commitment, utilization of a devoted change supplier, and

assistance of correspondence with outpatient suppliers require time and assets, there is proof that

neuro hospitalists can execute a transitional consideration program with the point of improving

patient wellbeing over the continuum of care (Kristen, 2015).

Outcome: Evidence-Based Research

Centers are tried with rethinking their restorative facility’s transitional thought practices,

to diminish 30-day readmission rates, prevent adversarial events, and assure a shielded

advancement of patients from crisis facility to home. Notwithstanding the extending thought in

regards to transitional thought, there are not really any conveyed examinations that have shown

enormous quantities in readmission rates, particularly for patients with stroke and other

neurologic discoveries.

Productive crisis facility began transitional thought programs consolidate an “interfacing”

framework with both pre-discharge and post-discharge intercessions, and submitted progresses

provider required at various concentrations in time. Notwithstanding the way that

multicomponent systems including tolerant responsibility, usage of a committed change

provider, and the help of correspondence with outpatient providers require time and resources,

there is evidence that neuro hospitalists can execute a transitional thought program with the

purpose of improving patient prosperity over the continuum of care.

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Hansen and associates played out a methodical audit of 43 intercessions to diminish 30-day

medical clinic readmission. Overall, the nature of concentrates was low, with just 16 being

randomized controlled preliminaries (RCTs). Most examinations (56%) tried the impact of

single-segment mediations, while the rest of the groups. The creators portrayed a scientific

categorization of mediation parts including general classes of pre-discharge intercessions (e.g.,

tolerant training, release arranging, drug compromise, arrangement planned before release); post-

discharge intercessions (e.g., opportune development, convenient PCP correspondence, follow-

up call, persistent hotline, home visit); and connecting mediations (e.g., change mentor, quiet

focused release directions, supplier progression).

Of the 16 RCTs, just 5 yielded critical decreases in clinic readmission. One of these gave

early release arranging (a solitary segment intercession) to high-chance patients. One little pilot

study and three bigger investigations actualized multicomponent mediation packs, which brought

about supreme decreases in 30-day readmission of 3.6 to 28 rate focuses (Sunil, 2013).

A special clinical requirement of the agency:

The patients need to have appropriate follow-up appointments as ordered, the patients

in turn need to modify their lifestyle and take medications as ordered.

Proposed schedule/timeline:

format issues on the document; running head and page numbers are not at the top of the page

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are there any agency policies currently related to your topic?

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The proposed time is 14 weeks to complete the process, and all the six steps will be

carried out without the allotted time.

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Collaboration with the preceptor:

The preceptor will continue to assist in providing resources as gathered. Also giving

insight as necessary. Lastly, meeting to address concerns from preceptee. Preceptor also provides

extra support by permitting preceptee to attend stroke alerts, and stroke rounds.

Proposed evaluative criteria:

It is necessary for patients to follow the discharge instructions from the physician.

This is to include a healthy diet, and adequate exercise weekly. The patient will also begin

smoking cessation if necessary. Furthermore, the patient will attend monthly stroke support

groups, and take medications as prescribed. These medications are to include blood pressure,

blood thinners, and cholesterol medications.

Evaluative criteria discussed:

The readmission of stroke patients will be observed and monitored carefully; this is to

reduce the instances of stroke readmissions.

Conclusion

Stroke is the condition when blood supply to any part of the brain. The capstone

project is about reducing stroke readmissions. This will occur by ensuring the patient knows the

risk factors, take the prescribed medications, following a heart healthy diet, and exercising. The

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you need to provide a step by step (weekly) time line of the capstone activities.
For example, the proposal is a guide to your activities: Which weeks/date will you be doing the intervention?
Please write this out and keep it for your own use so that you can keep up with the progress of the capstone

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this area should also include the proposed outcomes.
How do you plan to measure the outcomes?
Any comparison to the agency expectations?

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could have included the dates for the preceptor/faculty/student engagement here

efforts are being made to reduce the stroke readmissions to hospitals and it involves a lot of

factors. The patients should be given proper awareness and nurses should be educated so they

may treat the

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patients with care. The strategies should be designed and should be followed to reduce

readmissions (Bumpus, 2017).

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References

Bumpus, S. M. (2017). Transitional Care to Reduce Cardiac Readmissions: 5-Year Results from

the BRIDGE Clinic. Family Medicine and Disease Prevention.

Christina Condon, M. N., Sarah Lycan, M. N., & Pamela Duncan, P. P. (2015). Reducing

Readmissions After Stroke with a Structured Nurse Practitioner/Registered Nurse

Transitional Stroke Program. AHA .

Hefzy, H. K. (2017). A Transition of Care Program to Reduce Stroke Related Hospital

Readmissions. INTERNATIONAL STROKE CONFERENCE MODERATED POSTER

ABSTRACTS.

Kristen. (2015). Reducing Stroke Readmissions in Hospitals. Nursing Journal.

Stephanie Rennke. (2015). Transitional Care Strategies from Hospital to Home. NCBI, 35-42.

please use the APA textbook to learn how to format reference items

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Purpose