Date of Award

Spring 5-28-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Michael Terry, DNP, FNP, PMHNP

Abstract

High rates of 30-day readmission after acute care discharge are a big concern for patients with psychiatric disorders. These high rates not only reflect poor patient outcomes, but also result in higher hospital costs. For adults with schizophrenia spectrum disorders (SSDs), a review of current research shows that non-adherence to medication has been significantly associated with rapid readmissions and that using an intervention such as follow-up telephone calls after discharge can help prevent readmission through increased medication adherence. Using the Iowa model framework as a guide, the purpose of this evidence-based practice project was to pilot a post discharge procedure that implemented weekly telephone calls to improve medication adherence and decrease rapid readmission for these adults. Follow-up calls that provided treatment and medication support were initiated within 1 week of a patient’s discharge and continued for 4 weeks. Weekly medication adherence data were acquired from participant recorded and reported scores using the Medication Adherence Report Scale-5 (MARS-5) self-report tool, and pre- and post-intervention 30-day readmissions information was obtained from a review of relevant patient medical records. Overall results revealed an increase in patient medication adherence and a decrease in 30-day readmissions. Consequently, the positive results of this small-scale pilot project reinforce the effective use of post discharge telephone follow-up to help prevent readmission through increased medication adherence for this patient group and provide support for a larger-scale application moving forward.

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