Date of Award

2023

Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chair

Tracy Lakin

Committee Member

Ila Mapp

Subject(s)

Hospitals--Home care programs--Evaluation, Acute diseases--Nursing

Abstract

A hospital-at-home program enables patients to receive hospital-level care at home as an alternative to traditional hospital care. Literature on hospital-at-home programs has demonstrated decreased mortality, 30-day readmissions, and length of stay, as well as increased satisfaction. Yet, there are gaps in the literature regarding comprehensive program evaluations. The purpose of this DNP project was to conduct a comprehensive program evaluation retrospectively analyzing mortality, length of stay, patient satisfaction, hospital-acquired infections, specifically central line bloodstream infections and catheter-associated urinary tract infections, and 30-day readmissions in patients enrolled in the Advanced Care at Home (ACH) program. A retrospective chart review of all patients admitted to ACH from August 30, 2021, to August 31, 2022, was conducted. For comparison, electronic health records were used to identify a cohort of similar patients, with selected ICD10 diagnoses who received traditional hospital care. The primary outcome variables collected were the length of stay, mortality, patient satisfaction, central line bloodstream infections, catheter-associated urinary tract infections, and 30-day readmissions. The variables of age, gender, race, ethnicity, and diagnosis-related groups will provide demographic information for descriptive purposes of the patient population. Compared to those receiving in-hospital care, results suggest that ACH patients have a shorter length of stay and a decrease in mortality, central line bloodstream infections, and catheter-associated urinary tract infections, in addition to increased patient satisfaction and 30-day readmissions.

Available for download on Wednesday, June 11, 2025

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