Author Biographical Info

Kaitlyn Bauer is a BSN to DNP Candidate at the Cizik School of Nursing, focusing on the Family Nurse Practitioner track. Her nursing experience has been chiefly with advanced heart failure patients in the Texas Medical Center. She has a passion for preventative care, helping to reform the current healthcare system, emphasizing healthcare literacy, and improving quality of life.

Date of Doctor of Nursing Practice Project Completion

Summer 8-2-2024

Faculty Advisor

Kala Christopherson

Abstract

Abstract

Purpose: Discharge processes for patients with heart failure on home intravenous inotrope support is fraught with barriers and complexities, and causes patients, caregivers, and bedside nurses’ high levels of stress leading to potentially unsafe, complicated discharges. This project aimed to decrease discharge times and improve nurses’ ability to safely and effectively discharge patients.

Background: The project was implemented in a 42-bed advanced heart failure IMU in the Texas Medical Center, where discharge times were longer than hospital standards at over 6 hours.

Methodology: Using elements of the Transition of Care Model, a discharge checklist was created to help staff prepare and organize discharge needs. Staff were educated on the use of the tool prior to implementation and cyclically during the project. Surveys were sent out to nursing staff before and after implementation to gauge staff opinion on discharge processes. Changes to the project were employed according to the Plan-Do-Study-Act quality improvement method.

Results: The checklist decreased discharge time by an average of one hour when comparing nine patients’ pre-implementation to nine patient’s post-implementation. Feedback from bedside staff found that the nurses felt the discharge checklist helped make the discharge process more organized, and patients were more prepared upon discharge.

Implications: A discharge checklist can improve discharge times and improve staff discharge capabilities and standardization for patients going home on IV milrinone. However, altering the standard workflow of a unit and brining on new initiatives leads to challenges in the sustainability of a discharge checklist.

Keywords

Milrinone, discharge planning, transition of care, case management, nursing, intermediate medical unit, transition of care

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