NURS FPX 8045 Assessment 7: DNP Literature Review and Intervention Proposal

Conceptualizing a Potential Project-Signature Assessment

A critical gap exists in the communication and collaboration between nursing staff and inpatient care providers during patient discharge at We Level Up Treatment Lawrenceville. This inconsistency in communication often leads to negative outcomes, such as increased hospital readmission rates for patients with Substance Use Disorders (SUDs), as highlighted by Sinclair et al. (2024). The Agency for Healthcare Research and Quality’s (AHRQ) Re-Engineered Discharge (RED) Toolkit offers a promising solution to enhance discharge protocols by fostering improved communication and care collaboration among healthcare providers, ultimately aiming to reduce readmissions (AHRQ, 2023). Addressing this communication and collaboration deficit is crucial for establishing more harmonious and effective discharge practices at We Level Up Treatment Lawrenceville. The PICOT question guiding this DNP project is:

In nurses working in a medicine and alcohol treatment facility (P), how does the implementation of the AHRQ’s RED Toolkit (I), compared to current discharge practices (C), affect hospital readmissions (O) over twelve weeks (T)?

Part 2: Analysis and Synthesis of Research

The literature concerning the practice gap at We Level Up Treatment Lawrenceville consistently emphasizes the urgent need for enhanced communication and collaboration between nursing staff and inpatient care providers, particularly during the patient discharge process. This practice gap carries significant implications, as inconsistencies in discharge planning and follow-up care elevate the risks of relapse and hospital readmissions among individuals with SUDs. A comprehensive review of research on interdisciplinary collaboration, cultural responsiveness, leadership, and tailored cooperative care models provides moderate-quality evidence (Level B) supporting the implementation of structured protocols and recovery-supportive interventions to bridge identified gaps and improve patient outcomes.

The Role of Recovery-Oriented Discharge Planning

Sinclair et al. (2024) provide compelling evidence that underscores the value of recovery-oriented discharge planning in SUD treatment, directly addressing the prevalent issue of inconsistent communication and collaboration. Their analysis of 25 studies reveals that post-discharge services, such as peer support, case stability, and interagency collaboration, significantly enhance long-term recovery outcomes by promoting trust and continuity of care. These findings strongly align with the needs at We Level Up Treatment, where fractured follow-up care currently impedes successful recovery.

A comprehensive review by Sinclair et al. (2024) supports a recovery paradigm, emphasizing the critical role of effective communication between providers and structured discharge processes. Moderate-quality evidence from this review substantiates the identified practice gap by demonstrating that cooperative discharge planning can mitigate relapse risks and reduce hospital readmissions. However, while the review highlights effective discharge strategies, it lacks specific implementation styles tailored to diverse settings, especially those with limited resources. This absence creates a knowledge gap regarding how to adapt and apply communication strategies effectively in varied healthcare environments.

Addressing Co-Occurring Disorders with Cooperative Care Models

Osilla et al. (2022) offer valuable insights into addressing co-occurring disorders, such as opioid use disorder (OUD) alongside mental health issues like PTSD and depression. These complex conditions often complicate discharge planning due to inadequate collaboration and communication. Osilla et al. (2022) championed a cooperative care model in New Mexico that incorporates community health workers and dimension-based care to more effectively coordinate services for complex cases.

This research is highly applicable to the practice gap at We Level Up Treatment, where nursing staff frequently encounter challenges related to co-occurring disorders among SUD patients. The adaptation of their cooperative care model, named CLARO, demonstrates that engaging community health workers in care collaboration fosters patient advocacy and improves care accessibility, particularly in low-resource settings. According to the evidence hierarchy model, the moderate-quality evidence presented by Osilla et al. (2022) supports the use of tailored approaches to manage dual diagnoses and highlights the need for integrated care collaboration. Nevertheless, the study’s reliance on a limited sample in a specific geographic area of Mexico restricts its generalizability, raising questions about the model’s relevance in more diverse settings and indicating a need for further research to evaluate its robustness across different patient populations.

Enhancing Communication Through Interdisciplinary Collaboration

Interdisciplinary collaboration, as explored by Kools et al. (2022), provides another foundational approach for addressing the inadequate communication practice gap. Using a mixed-methods approach, they examined structured protocols in Alcohol Use Disorder (AUD) treatment to improve outcomes through enhanced interdisciplinary communication. Social network analysis conducted within a hospital setting revealed that stronger connections among network partners improve AUD treatment quality and reduce barriers to patient engagement.

These findings underscore the importance of structured protocols and interdisciplinary cooperation, aligning perfectly with the need for standardized discharge protocols at We Level Up Treatment. Moderate-quality evidence from Kools et al. (2022) suggests that establishing harmonious and proper communication channels among healthcare providers can strengthen team cohesion, promote seamless care transitions, and reduce fragmentation. However, the study does not fully address the practical application of these findings, especially in inpatient settings with limited resources and staffing constraints, indicating a need for further exploration.

Culturally Responsive Interventions for Diverse Populations

Hirchak et al. (2020) emphasized culturally responsive interventions as critical for effective communication and collaboration in SUD treatment, particularly within culturally diverse patient populations. A mixed-methods study by Hirchak et al. (2020) on culturally adapted SUD treatments for American Indian communities revealed that community engagement and cultural re-centering foster meaningful patient-provider relationships. The authors employed the Interactive Systems Framework to evaluate culturally applicable approaches, facilitate recovery, and improve treatment efficacy.

These findings indicate that culturally adapted practices strengthen connections between patients and providers, an aspect directly applicable to We Level Up Treatment, where multicultural considerations are essential in bridging the communication gap during patient discharge. Hirchak et al. (2020) provided moderate-quality evidence (Level B) supporting the integration of cultural adaptations into discharge planning to foster better patient engagement and continuity of care. Still, their findings highlight an area of inquiry regarding the long-term sustainability of culturally adapted interventions, particularly in settings where cultural resources and workforce are limited. Further research is needed to evaluate culturally responsive communication adaptations that can be sustained and expanded across different SUD treatment settings.

The Impact of Transformational Leadership

Guerrero and Khachikian (2020) examined transformational leadership’s impact on communication and collaboration within SUD treatment programs. Applying case analysis methods predicated on transformational leadership theories, their study demonstrates that leadership styles emphasizing evidence-based practices and clear communication foster an organizational climate conducive to staff engagement and patient-centered care. Transformational leadership encourages trust and responsibility, directly addressing the practice gap identified at We Level Up Treatment. Moderate-quality evidence indicates that effective leadership can enhance team collaboration, especially in resource-limited SUD treatment facilities. However, while the study underscores the value of transformational leadership, it does not fully detail the specific strategies for developing such leadership within existing organizational structures, particularly in challenging environments.Save time and score higher with our well-researched NURS FPX 8045 Assessment 7: Strategies for Success and Preparation sample paper.