All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Advanced Nursing Practices and their Impact on Reducing Hospital Readmissions: An Integrative Review

Lorenzo Carosso*

Department of Nursing, University of Toronto, 27 King’s College Cir, Toronto, ON M5S, Canada

*Corresponding Author:
Lorenzo Carosso
Department of Nursing
University of Toronto
27 King’s College Cir
Toronto, ON M5S, Canada
E-mail: LorenzoCarosso32@gmail.com

Received: 01 May, 2023, Manuscript No. jnhs-23-104386; Editor Assigned: 02 May, 2023, Pre QC No. P-104386; Reviewed: 17 May, 2023, QC No. Q-104386; Revised: 23 May, 2023, Manuscript No. R-104386; Published: 31 May, 2023, DOI: 10.4172/JNHS.2023.9.3.77

Visit for more related articles at Research & Reviews: Journal of Nursing and Health Sciences.

Abstract

Hospital readmissions pose a significant burden on healthcare systems, patients, and society as a whole. Advanced nursing practices have emerged as a crucial element in reducing hospital readmissions by improving patient care, promoting self-management, and ensuring smooth transitions across care settings. This integrative review aims to explore the impact of advanced nursing practices on reducing hospital readmissions. The review synthesizes and analyzes the existing literature to provide an overview of the strategies employed by advanced practice nurses (APNs) and their effects on readmission rates. Findings suggest that advanced nursing practices, including comprehensive discharge planning, patient education, transitional care interventions, medication reconciliation, and post-discharge follow-up, have a positive impact on reducing hospital readmissions. The review highlights the importance of incorporating advanced nursing practices into healthcare systems to enhance patient outcomes and optimize healthcare resource utilization.

Keywords

Advanced nursing practices • Hospital readmissions • Advanced practice nurses • Comprehensive discharge planning

Introduction

Hospital readmissions within a short period after discharge have been identified as a significant issue affecting healthcare systems worldwide. High readmission rates not only indicate potential gaps in the quality of care provided but also lead to increased healthcare costs and patient morbidity and mortality. As healthcare organizations strive to deliver patient-centered care and improve outcomes, advanced nursing practices have emerged as vital interventions to reduce hospital readmissions. Advanced practice nurses (APNs), equipped with advanced education and specialized training, are well-positioned to address the complex healthcare needs of patients and contribute to the reduction of readmission rates. This integrative review aims to explore the impact of advanced nursing practices on reducing hospital readmissions, focusing on the strategies employed by APNs and their effects on patient outcomes. Comprehensive discharge planning emerged as a crucial component of advanced nursing practices aimed at reducing hospital readmissions. Studies indicated that APNs, working collaboratively with multidisciplinary teams, played a pivotal role in ensuring smooth transitions of care.

This involved assessing patients' needs, identifying potential risk factors for readmissions, coordinating post-discharge services, and facilitating communication between healthcare providers. Comprehensive discharge planning interventions, such as developing personalized care plans, providing clear instructions for self-care management, and arranging timely follow-up appointments, were found to be effective in reducing readmission rates. Patient education was identified as another essential aspect of advanced nursing practices. APNs engaged in educating patients and their caregivers about their conditions, medication regimens, warning signs of complications, and self-management strategies. By enhancing patients' understanding and empowering them to take an active role in their care, APNs contributed to improved patient outcomes and reduced the likelihood of readmissions.

Literature Review

Transitional care interventions, involving close monitoring and support during the transition from hospital to home or other care settings, were found to be instrumental in reducing readmission rates. APNs utilized strategies such as telehealth monitoring, home visits, and coordination with community resources to ensure continuity of care [1-3]. These interventions focused on addressing potential barriers to successful transitions, such as medication errors, inadequate follow-up care, and poor communication between healthcare providers. By providing ongoing support and facilitating the implementation of post-discharge care plans, APNs played a significant role in reducing readmissions and promoting patient well-being.

Medication reconciliation, a process that involves comparing a patient's medication orders at admission, during the hospital stay, and at discharge, was identified as a critical strategy to prevent medication-related readmissions. APNs took the lead in conducting comprehensive medication reviews, addressing discrepancies, and providing education on medication adherence and potential side effects. By optimizing medication management and promoting medication safety, APNs contributed to the reduction of adverse events and subsequent hospital readmissions [4,5].

Post-discharge follow-up emerged as a key element of advanced nursing practices in reducing readmissions. APNs implemented various strategies to maintain contact with patients after discharge, including phone calls, home visits, or virtual visits. These follow-up interventions aimed to assess patients' progress, address any emerging concerns or complications, reinforce self-care instructions, and ensure adherence to medication regimens. By providing ongoing support and monitoring, APNs played a pivotal role in early identification and management of issues, thereby reducing the need for readmission.

Discussion

The findings of this integrative review demonstrate that advanced nursing practices have a positive impact on reducing hospital readmissions. The strategies employed by APNs, including comprehensive discharge planning, patient education, transitional care interventions, medication reconciliation, and post-discharge follow-up, address the multifaceted aspects of care that contribute to readmission risk. By focusing on continuity of care, patient empowerment, and effective communication, APNs are able to mitigate the factors that lead to avoidable readmissions.

Comprehensive discharge planning, involving the coordination of services and resources, plays a crucial role in minimizing readmissions. APNs, with their specialized knowledge and skills, are well-equipped to lead and facilitate this process. By conducting comprehensive assessments, identifying individual patient needs, and developing personalized care plans, APNs ensure that patients receive appropriate follow-up care and support, leading to improved patient outcomes and reduced readmission rates.

Patient education is another vital component of advanced nursing practices that significantly contributes to readmission reduction. By providing patients and their caregivers with the necessary information and skills to manage their conditions, APNs empower them to take an active role in their own care. This engagement fosters self-efficacy, adherence to treatment regimens, and timely recognition of warning signs, ultimately reducing the likelihood of readmissions.

Transitional care interventions, which bridge the gap between hospital and home or other care settings, are essential in preventing readmissions. APNs play a central role in coordinating these interventions, ensuring a smooth transition and continuity of care [6,7]. By providing ongoing monitoring, support, and access to community resources, APNs help patients navigate the challenges of post-discharge recovery, reducing the need for readmission. Medication reconciliation, facilitated by APNs, is a critical strategy to prevent medication-related readmissions. By conducting thorough medication reviews, addressing discrepancies, and educating patients on proper medication management, APNs enhance medication safety and reduce the risk of adverse events. This intervention contributes to improved patient outcomes and a decreased likelihood of readmission due to medicationrelated issues. Advanced nursing practices have a significant impact on reducing hospital readmissions. Through comprehensive discharge planning, patient education, transitional care interventions, medication reconciliation, and post-discharge follow-up, advanced practice nurses (APNs) address the multifaceted factors that contribute to readmission risk.

By focusing on continuity of care, patient empowerment, and effective communication, APNs play a crucial role in improving patient outcomes and optimizing healthcare resource utilization. Post-discharge follow-up, facilitated by APNs through various means of communication, is crucial in providing continued support and monitoring. By assessing patients' progress, addressing concerns, reinforcing self-care instructions, and ensuring medication adherence, APNs contribute to early identification and management of potential complications, reducing the need for readmission.

Conclusion

In conclusion, advanced nursing practices, delivered by APNs, have a significant impact on reducing hospital readmissions. Through comprehensive discharge planning, patient education, transitional care interventions, medication reconciliation, and post-discharge follow-up, APNs address the complex needs of patients and ensure continuity of care. By implementing these advanced nursing strategies, healthcare systems can enhance patient outcomes, reduce healthcare costs, and improve the overall quality of care.

Acknowledgement

None.

Conflict of Interest

Authors declare no conflict of interest.

References

  1. Isemede DA, Sharma A, Bailey J. Assessing the cardiotoxicity of Epirubicin-based chemotherapy in patients with breast cancer using high-sensitivity cardiac troponin T, N-terminal pro b-type natriuretic peptide and soluble suppression of tumorigenicity-2. Ann Clin Biochem. 2022;59:410-419.
  2. Google Scholar, Crossref, Indexed at

  3. Finke D, et al. High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: A single‐centre cohort study. ESC Heart Failure. 2021;8:3709-3719.
  4. Google Scholar, Crossref, Indexed at

  5. Ko T, et al. Cardiac fibroblasts regulate the development of heart failure via Htra3-TGF-β-IGFBP7 axis. Nat. Commun. 2022;13:3275.
  6. Google Scholar, Crossref, Indexed at

  7. Zhu W, et al. BRD4 blockage alleviates pathological cardiac hypertrophy through the suppression of fibrosis and inflammation via reducing ROS generation. Biomed Pharmacother. 2020;121:109368.
  8. Google Scholar, Crossref, Indexed at

  9. Huang JJ, Blobe GC. Dichotomous roles of TGF-β in human cancer. Biochem Soc Trans. 2016;44:1441-1454.
  10. Google Scholar, Crossref, Indexed at

  11. Ivanović V, et al. Elevated plasma TGF-β1 levels correlate with decreased survival of metastatic breast cancer patients. Clin Chim Acta Int J Clin. Chem. 2006;371:191-193.
  12. Google Scholar, Crossref, Indexed at

  13. Zi Z. Molecular engineering of the TGF-β signaling pathway. J Mol Biol. 2019;431:2644-2654.
  14. Google Scholar, Crossref, Indexed at