Date of Doctor of Nursing Practice Project Completion

Spring 2026

Faculty Advisor

Susan Stafford

Abstract

PURPOSE

The quality improvement (QI) project aimed to decrease readmission rates at the project site through implementation of a nurse-driven disease-specific discharge checklist when compared to the same timeframe the year prior.

BACKGROUND

The project site’s 2024 national ranking declined due to unplanned chronic obstructive pulmonary disease (COPD) readmissions. COPD readmissions remained at national average and was not nationally competitive. This metric increased cost to the hospital and contributed to worse quality outcomes for the patient.

METHODOLOGY

Project design used the IOWA Model Revised framework and supported with an evidence-based review of the literature. PDSA cycles were conducted during implementation. Data was collected and analyzed using mean and median methods to assess quantitative outcomes for participation in education sessions, compliance with checklist use, and presence of documentation addressing discharge barriers. Limitations due to sample size and time frame were acknowledged.

RESULTS

Phase two of implementation educated 90% of nursing staff. PDSA cycles at weeks 2 and 4 prompted re-education of staff on checklist use due to changes in staffing ratios and float nurse unfamiliarity with the project. Of 17 encounters, 94% used the checklist. Unplanned COPD readmissions failed to achieve the 5% reduction below 18.5% goal.

IMPLICATIONS

Generalizability of the project was limited by the small sample size and short project duration. The QI project is adaptable for use of disease-specific discharge checklists for other conditions. Sustainability of the QI project would be improved in other settings with electronic methods. Strong and sustained stakeholder engagement impacts project implementation success.

Keywords

COPD, Discharge, Checklist, Nurse-driven

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Nursing Commons

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