Grid Representation Evidence Level Capstone Project

This is intended to be a working tool to assist you with organization of evidence for the Capstone Narrative Paper. Do not use Systematic Reviews or Meta-analysis studies for this assignment. Only primary research should be entered on this grid. Only a typed document will be accepted.

Citation (APA)

Purpose

Sample

Design

Measurement

Results/Conclusions

Proposal Contribution

Ranking

Boden-Albala, B., Goldmann, E., Parikh, N. S., Carman, H., Roberts, E. T., Lord, A. S., Torrico, V., Appleton, N., Birkemeir, J., Parides, M., & Quarles, M. (2018). Efficacy of a discharge educational strategy versus standard discharge care on reduction of vascular risk in patients with stroke and transient ischemic attacks: The DESERVE randomized controlled trial. JAMA Neurology, 76(1), 20-27.

The study sought to assess the efficacy of a skill-based, culturally-tailored discharge education program with telephone follow-up vis--vis standard discharge care in reducing the risk of systolic blood pressure among patients with transient ischemic attack and stroke.

The sample comprised of 1,083 patients selected randomly, and visiting four medical centers in New York City with transient ischemic attacks or mild to moderate stroke

Randomized controlled trial (RCT) with 1 year follow-up

IV: Discharge educational strategy, Standard discharge care

DV: vascular risk

Participants in the intervention group were exposed to an interactive patient education at discharge that was facilitated by a community health nurse. Participants were given a patient video and workbook emphasizing the need for three skills: risk-reduction, medication adherence, and physician-patient communication. The intervention group also received follow-up phone calls from the community health nurse 72 hours, 1 month, and 3 months after discharge. The control group received standard discharge care that included receiving stroke pamphlets by the American Heart Association to minimize their exposure to vascular risk. Vascular risk was measured at baseline, 6months and 12 months using systolic blood pressure. Linear regression and analysis of variance (ANOVA) were used to test for relationships and associations between variables.

Results showed clinically significant differences in systolic blood pressure reduction between the intervention and control groups. The authors concluded that culturally-tailored, skill-based discharge education significantly reduced the risk of vascular disease among patients at 1-year follow-up

This study supports my proposal by lending credence to the effectiveness of enhanced discharge education programs in improving patient health outcomes, thus reducing the risk of revisits and readmissions that would increase wait times. The study also provides adequate insights on how to design a skill-based discharge education strategy for at-risk patients

VII.

deJong, N. A., Kimple, K., Morreale, M., Han, S., Davis, D., & Steiner, M. J. (2020). A quality improvement intervention bundle to reduce 30-day pediatric readmissions. Pediatr Qual Saf., 5(2), e264.

The study sought to determine the effectiveness of a quality improvement bundle aimed at reducing the readmission rates...…samples were selected randomly from patients visiting the ED of a California-based level 1trauma center serving an average of 260 patients daily

A quality improvement longitudinal design was implemented comparing patient satisfaction rates before the QI intervention (training of clinical staff on the teach-back method) and after implementation.

IV: the teach-back method used to educate patients at the time of discharge

DV: patient satisfaction

The level of patient satisfaction was measured using a standardized 16-item survey developed by the National Research Institute. The survey required users to indicate their level of agreement or disagreement with provided statements on a four-point Likert scale. Patient satisfaction was calculated as a percentage from their responses and the percentages compared pre and post-implementation

61% of patients reported that they were satisfied with the discharge education offered post-intervention as compared to 59% in the pre-intervention phase. However, no significant variations were present in the two sets of data, leading the authors to conclude that the teach-back method may improve patient satisfaction when used for discharge education.

This study supports my proposal by introducing the teach-back concept, which is the strategy that the clinical staff in the capstone project use to deliver discharge education to patients. The capstone project will adopt the methodology used in this study to test the effectiveness of its discharge education program in reducing overall revisits…

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