Date of Award

Spring 5-28-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Joseph Burkard DNSc, CRNA


Background: On average, patients experience one to seven problems post-hospital discharge leading to increased unplanned emergency room visits, hospital readmission, and worse outcomes. The average cost of a single hospital admission is $15,477, an emergency room visit $1,389, and treatment for a surgical site infection $10,443-$25,546. Additionally, the Center for Medicare and Medicaid Services (CMS) imposes fines on hospital systems with high readmission rates. Currently, the Southern California hospital this project was implemented at has a 15.5% hospital-wide unplanned 30-day readmission rate with a national average of 15.2%.

Purpose: The purpose of this evidence-based practice project was to implement a Nurse Practitioner (NP) led post-discharge telephone follow-up program to improve quality of life and medications adherence among same day vascular surgery patients.

Methods: The target population for this project was same day vascular surgery patients. Eight patients were recruited and enrolled from September 2021 to February 2022. Each patient was administered the PROMIS Global Health and Medication Adherence Questionnaire (MAQ) questionnaires pre-procedurally and during follow-up calls at 3-, 7-, and 14-days. Additionally, during the phone follow-up, the NP reinforced discharge instructions and medication adherence.

Results: Fifty percent of patients showed improvement in their MAQ score 2 weeks following care. In addition, 50% of patients showed an increase in their PROMIS Global Physical Health T-score, and 25% of patients had an increase in their PROMIS Global Mental Health T-score at 2-weeks follow-up.

Implications: Unplanned post-discharge emergency room visits and hospital readmissions remain a challenge to efficient quality care. A NP led post-discharge telephone follow-up is a simple and cost-effective intervention that increases patient medication adherence and improves patient outcomes and quality of life.