Date of Award

2019-05-25

Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Cynthia D. Connelly, PhD, RN, FAAN Member; Tavonia Ekwegh, DNP, RN, Member

Keywords

African American, Black, COPD, Chronic Obstructive Pulmonary Disease, Safety-Net Hospital, HRRP

Abstract

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second leading cause of hospital readmissions with a projected cost of $101 billion by 2020. Simply penalizing hospitals for increased readmission rates, rather than understanding extrinsic and intrinsic influencing factors from the patient’s perspective, could lead to increased disparities among certain populations.Objective:The purpose of this study is to explore the lived experience of African American (AA) COPD patients readmitted to a community hospital, within 30-days of a previous discharge.

Sensitizing Model:Transitional Care Model

Research Aims:To explore the lived experience of AA COPD patients discharged from the hospital and readmitted 30-days post discharge. To explore recently discharged AA patient’s management of COPD in their homes and within the community.

Methods:The purpose of this study is to explore the lived experiences of readmitted AA patients with COPD. An interpretive phenomenology research approach will be adopted to collect data through semi-structured interviews. Data will be collected, analyzed, and written using the scientific methodology of hermeneutic phenomenology.

Findings: Lacking educational attainment, coupled with a lack of knowledge or health literacy about COPD, are social considerations that should be considered when developing strategies to decrease readmission rates within this vulnerable population.

Implications: The Hospital Readmission Reduction Program is designed to improve quality and reduce hospital readmissions for conditions such as COPD; however, based on the participant interviews, this study reveals that factors beyond hospital walls also play an important role in readmission rates.

Document Type

Dissertation: Open Access

Department

Nursing

Available for download on Monday, May 10, 2021

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