College of Nursing and Health Sciences DNP Defense - Michelle Martinis, MSN,RN,AGACNP-BC, CWCN-AP
Title: The Exploration of Patient Readiness to Discharge in Adults Undergoing Colonic Ostomy Creation
Student: Michelle Martinis, MSN, RN, AGACNP-BC, CWCN-AP
Committee:
Faculty Mentor: Mark Adelung, PhD, RN, CPH
Committee Member: Ouida Dowd, PhD, RN, ACNS-BC, CCRN
Clinical Site Mentor: Elizabeth Henderson, PhD, RN
Abstract:
Background: Patients undergoing surgical ostomy creation are experiencing adaptation challenges in psychosocial aspects, self-care management, coping abilities, and health knowledge. This rapid adjustment can cause discharge readiness deficits, leading to increased complication rates and higher readmission rates.
Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate readiness for discharge among patients with a new ostomy within 24 hours of transitioning home at a moderate-sized community hospital in southeastern Massachusetts.
Methods: A mixed-methods design was used. Adult patients undergoing new ostomy creation completed the 21-item Readiness for Hospital Discharge Scale (RHDS) and a brief five-question open-ended interview within 24 hours of discharge. Quantitative data were analyzed using descriptive statistics, Cronbach’s alpha reliability testing, and a one-sample t-test comparing RHDS scores to published benchmark values. Qualitative interview responses were analyzed using Braun and Clarke’s thematic analysis.
Results: Ten participants completed the RHDS survey, and seven participated in interviews. The overall RHDS mean score was 4.02 (SD = 0.92), significantly lower than published benchmark scores (p<.001). The knowledge domain demonstrated the lowest scores, followed by psychosocial readiness, while expected support scored the highest. Qualitative findings supported these results, identifying themes related to education gaps, anxiety regarding ostomy self-management, and the need for structured discharge teaching.
Conclusion: These findings suggested that patients with new ostomies may be discharged before achieving optimal readiness for self-care. Implementing standardized discharge readiness assessments and enhanced ostomy education may improve patient preparedness and reduce postoperative complications and readmissions.
ZOOM
Deanna Hoffman
dhoffman@umassd.edu