READI – Readiness Evaluation and Discharge Interventions Study Phase 1 orientation for float nurses Description: Technical Contact: This course is designed to explain the READI ( Readiness Evaluation and Discharge Interventions Study). It will take approximately 10 minutes to complete this course. If you have technical questions please contact the Service Desk at Insert your Learning platform help desk info here. This learning session is the introduction to the READI study and training in the procedures for Phase 1 of the study. READI stands for READINESS EVALUATION and DISCHARGE INSTRUCTIONS. Content Contact: Insert PI or Educator name and contact information

Learning Objectives This presentation is designed to be used for float nurses who provide care to patients being discharged from the READI study implementation unit. Upon completion of the learning session, the nurse will be able to: Complete the RN-RHDS discharge readiness assessment Follow READI study procedures. This presentation is designed to be used for float nurses who provide care to patients being discharged from the READI study implementation unit. Upon completion of the learning session, the nurse will be able to: Complete the RN-RHDS discharge readiness assessment Follow READI study procedures.

READI Study READI: Readiness Evaluation And Discharge Interventions Multi-site study, commissioned by the American Nurses Credentialing Center and led by nurse researchers from Marquette University, University of Maryland, and University of Michigan. The READI study is a multi-site study commissioned by the American Nurse Credentialing Center, the organization that leads the Magnet Recognition Program and led by nurse researchers from Marquette University, University of Maryland, and University of Michigan.

If you have questions: Ask your charge nurse or other RNs on the unit Or Ask them to contact the READI study PI or study educator at your site If you have questions about READI study or about completing the discharge readiness assessment, you can ask: Your charge nurse Other RNs on the unit The READI site principal investigator or educator.

READI STUDY AIMS To determine the impact on post-discharge utilization (readmissions and ED visits) and costs of implementing discharge readiness assessment as a standard nursing practice for adult medical-surgical patients. The READI study is an implementation study that translates findings from prior research conducted by the READI team and other researchers into clinical practice. The purpose of the study is to determine the impact on post-discharge utilization, specifically readmissions and ED visits, and costs, of implementing discharge readiness assessment as a standard nursing practice for adult medical-surgical patients.

Tool for Discharge Readiness Assessment Readiness for Hospital Discharge Scale – Short Form RN-RHDS (Weiss et al., 2010, 2014) 8 questions 0-10 point scale Higher scores = greater readiness Completed by the discharging nurse on the day of discharge (within 4 hours before discharge) Assessment should be used by the nurse in conjunction with all other nursing assessments to determine individualized nursing interventions as needed. RNRHDS takes about 5 minutes to complete The tool to be used for discharge readiness assessment is the Nurse version of the Readiness for Hospital Discharge Scale, short form – called the RN-RHDS. It consists of 8 items with responses scored on a 0 to 10 scale. High scores mean greater readiness. The tool is completed by the discharging nurse normally within 4 hours before the patient is discharged. The assessment should occur in conjunction with all other nursing assessments to determine individual nursing interventions needed for the patient prior to discharge. The RN-RHDS takes about 5 minutes to complete.

RN-RHDS: 8 Questions in 4 Subscales Patient’s Personal Status How physically ready is your patient to go home? How would you describe your patient’s energy today? The RN-RHDS contains 8 questions in 4 subscales, The first subscale is Patient’s Personal Status, with 2 questions: How physically ready is your patient to go home? How would you describe your patients energy today? These items are scored on a 0-10 scale from Not Ready to Totally Ready and Low Energy to High Energy The items are screening items for potential issues with personal status. Note the other items to consider that may also be relevant. Consider pain/discomfort, strength, emotional readiness, physical ability to care for self

Patient’s Knowledge RHDS Subscales How much does your patient know about problems to watch for after going home? How much does your patient know about restrictions (what he/she is allowed and not allowed to do) after going home? The second subscale is Patient’s Knowledge, with 2 questions: How much does your patient know about problems to watch for after going home? How much does your patient know about restrictions (what he/she is allowed and not allowed to do) after going home? These items are scored on a 0-10 scale from Know Nothing at All to Know All The items are screening items for potential issues with knowledge. Note the other items to consider that may also be relevant. Consider caring for self at home, taking care of personal or medical needs, who/when to call for problems, what happens next in follow-up treatment plan, available community services

Patient’s Coping Ability RHDS Subscales Patient’s Coping Ability How well will patient be able to handle the demands of life at home ? How well will your patient be able to perform his/her personal care ( for example, hygiene, bathing, toileting, eating) at home? The third subscale is Patient’s Coping Ability, with 2 questions: How well will your patient be able to handle the demands of life at home? How well will your patient be able to perform his/her personal care (for example, hygiene, bathing, toileting, eating) at home? These items are scored on a 0-10 scale from Not at All to Extremely Well The items are screening items for potential issues with coping ability. Note the other items to consider that may also be relevant. Consider ability to perform his/her medical treatments

Patient’s Expected Support RHDS Subscales Patient’s Expected Support How much help will your patient have with personal care after he/ she goes home? How much help will your patient have with medical care needs (medications, treatments) at home? The fourth subscale is Patient’s Expected Support, with 2 questions: How much help will your patient have with personal care after he/she goes home? How much help will your patient have with medical care needs (medications, treatments) at home? These items are scored on a 0-10 scale from None to A Great Deal The items are screening items for potential issues with expected support. Note the other items to consider that may also be relevant. Consider emotional support, help with household activities

Nurse Assessment Form Complete the RN RHDS by answering the questions in the left column. Circle the number between 0 and 10 that best corresponds to your assessment of the patient. There are also a few additional questions at the bottom that help to describe your patient’s situation.

Instructions for Completing the RN-RHDS Who All patients discharged to home Includes patients going to family homes or independent living communities When The RN-RHDS should normally be completed within 4 hours before discharge. Usually completed after the majority of discharge teaching has been completed. Allow time to respond to any concerns identified in the RN-RHDS. Use your nursing judgment to determine appropriate interventions Use the following instructions to complete the RN-RHDS for Phase 1 Complete the RN-RHDS on all patients going home. Include patients going to family homes or independent living communities The RN-RHDS should normally be completed within 4 hours prior to discharge, normally after the majority of discharge teaching has been completed. Allow time to respond to any concerns identified in the RN-RHDS. Use your nursing judgment to determine appropriate interventions.

Instructions for Completing the RN-RHDS (Paper version) Place patient label on the bottom of the RN-RHDS form Fill in RN Research ID Answer the 8 RN-RHDS questions and the 5 additional patient descriptor questions. Place completed forms in the designated location on your unit for the READI STUDY forms Complete the following steps: Place the patient’s label (the label generated by your hospital for identifying patient records) at the bottom of the RN-RHDS form. Fill in your RN Research ID. The study team at your hospital will tell you how to select your RN Research ID number. Answer the 8 RN-RHDS items and the additional questions about the patient. Place completed form in the assigned location on your unit.

Human Subjects Protection Approved through Marquette University IRB and your hospital IRB Data will be reported only in aggregate form The researchers will not be able to identify specific patients or nurses. We use the RN Research ID only for statistical purposes (to adjust for a nurse taking care of multiple patients in the study). All patient-level data will be de-identified by your site PI before it is released to the research team. All research requires protection of the rights of human subjects. The study has been approved by Marquette University IRB and your hospital IRB. The data will be reported in aggregate form only. The researchers will not be able to identify specific patients or nurses We will use Nurse Research IDs only for statistical purposes to adjust for nurses taking care of multiple patients in the study. All patient-level data will be de-identified by your site PI before it is released to the research team.

Privacy Patient Patient Labels will be removed before sending to the study team Label information is needed by your site Principal Investigator to request readmission and patient descriptors from EHR Nurse The study team will not be able to link Nurse IDs to a specific nurse. No information will be provided to your hospital administration regarding specific nurses or their individual discharge readiness assessments Participant privacy is an important consideration in all research activities. Patient labels will be removed from study forms before sending the data to the research team Label information is needed by your site Principal Investigator to request readmission and patient descriptors from the Electronic Medical Record The study team will not be able to link RN Research IDs to specific nurses. No information will be provided to hospital administration regarding specific nurses or their individual discharge readiness assessments.

Ready for READI Complete a RN-RHDS discharge readiness assessment for every patient discharged home. Thank you for your participation in this important nursing research project. You are now ready to do the Discharge Readiness Assessment. Remember the goal is to use the RN-RHDS discharge readiness assessment for every patient discharged home. Thank you for your participation in this important nursing research study.