Effect of INTERACT on Promoting Nursing Staff’s Self-Efficacy Leading to a Reduction of Rehospitalizations from Short-Stay Care

Abstract

One in four clients discharged from an acute care facility to a skilled nursing facility (SNF) required readmission to the hospital within 30 days. Neuman, Wirtalla & Werner believe that two-third of those readmissions are avoidable. Reducing the frequency of rehospitalization from short-stay care is essential for two primary reasons: 1) Clients are exposed to hospital-acquired infections that lead to increased comorbidities, and 2) potentially avoidable hospitalization will decrease the amount of funding distributed by Medicare. The setting for the proposed change initiative was a for-profit, nondenominational SNF in Missouri. Of the 120 beds, 16 were devoted to short-stay care. The convenience sample included four registered nurses and eight licensed practical nurses who had agreed to participate in the pilot. The purposive sample included short-stay clients. Interventions implemented at the pilot skilled nursing facility are components of the validated INTERACT quality improvement program. INTERACT (Appendix A) is comprised of several tools designed to assist and guide front-line staff in early identification, assessment, communication, and documentation about acute changes in client condition. Measured results examined the effectiveness of the proposed intervention. The outcome being assessed in the project was the number of avoidable hospital admissions after implementation of the INTERACT quality initiative tools. The long-term objective for the pilot was a 2% decrease in client rehospitalizations from the short-care unit during the eight weeks of practice implementation. The clinical question for the proposed practicum project was, “For the nursing staff on a short-term rehab unit, does the implementation of an evidence-based patient evaluation tool, INTERACT lead to a reduction in avoidable hospital admissions?”.