School of Nursing
Doctor of Nursing Practice (DNP)
Revocations, Hospice, POST, Compliance, Quality, Readmissions, Outcomes
Medicine and Health Sciences | Nursing
Asselin, Joanna Grace, "Implementation of Post Forms upon Hospice Admission: An Evidence-Based Practice Intervention to Reduce Hospice Revocations" (2020). Doctoral Dissertations and Projects. 2593.
Background and Purpose: Reduction of live hospice discharges in the form of revocations is necessitated in order to maintain regulatory compliance and meet quality measures. Upon admission to hospice services, many have not considered personal desire regarding further intervention beyond Do Not Resuscitate (DNR) status. Evidence-based practice has revealed Physician Order for Scope of Treatment (POST) forms as effective in enhancing translation of patient desires related to care and interventions at end-of-life. The clinical question of this scholarly project asked if implementation of POST forms upon admission to hospice services would result in decreased revocations with related emergency department (ED) visits and hospital readmission reduction when compared to those not utilizing POST forms. Conduction of an in-depth literature review was performed to support the proposed question. Implementation of POST forms upon admission to hospice services to facilitate end-of-life wishes, decrease revocations, emergency department visits and hospital readmissions was supported. Proposed Project Methods: Based upon the nature of the Doctor of Nursing Practice (DNP) scholarly project, an evidence-based practice project has been conducted. This involved a quantitative, non-experimental pilot project utilizing the Iowa Model as the foundational framework. Outcome measures were guided by a cross-sectional correlational design due to time restraints. A convenience sample of 8-15 patients had POST form reviewed upon hospice admission by a POST facilitator from January 27th – February 29th. Completion of the form was voluntary. Outcomes in the form of revocations, emergency department visits and hospital readmissions were reviewed and compared with those having not received POST intervention.