Date Available

12-1-2016

Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Sheila Melander

Committee Member

Dr. Chizimuzo Okoli

Co-Director of Graduate Studies

Lynn Hundley

Abstract

PURPOSE: The purpose of this study is evaluate the APRN care model utilized for stroke patients by examining the pre and post impact on outcomes of the stroke clinical practice guidelines (CPGs), patterns of service use, stroke patient outcomes, and patient satisfaction.

METHODS: This study was a single-center, pre-post implementation retrospective study of the impact for the stroke APRN care model on the stroke patient population at Norton Brownsboro Hospital. The sample consisted of 145 patients for the pre-implementation period, March 2012 to August 2012, and 202 patients for the post-implementation period, March 2014 to August 2014.

RESULTS: No differences in age, sex, ethnicity, comorbidity burden, and diagnosis code were found between the pre and post groups. Patients managed by the APRNs had a significantly shorter LOS (P = < .001), decreased ICU recidivism (P = .01), reduced inpatient mortality, and increased discharges to home (P = .02). No differences were found between groups in readmission rates or patient satisfaction. The APRN managed group had a median decreased LOS of two days,resulting in an approximated cost savings of $628,056.00 in six months.

CONCLUSION: Clinical and financial outcomes were significantly improved by implementing an APRN care model. In a healthcare environment where quality and cost efficient care is paramount, the APRN care model is effective in achieving these initiatives. Adding an APRN to the health care team sets the standard for quality patient care and reducing hospital-associated costs.

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