Read intructions

Influence of Transitional Care in Hospital Readmission among Elderly Patients.

Dania Morejon

Florida National University

May 27, 2021

Barry Graham
Please place headings within your paper.

Barry Graham
Please address your title page requirements.


Influence of Transitional Care in Hospital Readmission among Elderly Patients.

Transitional care is offered to a patient when they are leaving one care setting such as a

hospital, nursing home or intensive care unit into another setting. Transitional care interventions

ensure the continuity of quality care to the patient and the coordination of healthcare between

different healthcare providers (Menezes et al., 2019). Successful transitions require trained

practitioners and health plans indicating the patient’s medications, previous treatment plans, and

healthcare preferences. Transitional care can occur within care settings such as from primary care

to intensive care, between settings such as from a nursing home to a hospital, between healthcare

providers such a specialist to a palliative care medical provider, or across different health

conditions. Transitional care is critical for older patients since they have unique needs compared to

other populations especially when transitioning from the hospital to nursing homes or individual

residences (Menezes et al., 2019). Lack of proper transitional care may lead to emergency hospital

readmissions and other medical unplanned events.

Multiple complicated conditions are barriers to managing healthcare needs among older

patients. Care transition is thereby important for this population to reduce the risk of infections and

readmission (Fønss et al., 2021). Nurses ensure the environment and the services provided are safe

for effective passage from one setting or specialist to the other. Older patients receive diverse

forms of care from different healthcare providers owing to multiple chronic conditions. They are in

the greatest need of successfully transitional care. Poor transitional care leads to unpleasant events,

dissatisfaction, and mistrust of the healthcare institution and medical providers, and a high

readmission rate.

Previous literature has identified various factors associated with ineffective transitional

care. Some of these include poor communication between medical providers, incomplete patient


information, lack of awareness and education among older patients, and cultural and language

barriers (Fønss et al., 2021). These factors lead to gaps in the provision of quality healthcare

among older patients. Religious and cultural barriers can be especially challenging to nurses due to

a lack of cultural-based competency. Some religions such as Islam state that make members of the

family or heads of households should make decisions for every member of the family. Women are

not allowed to make decisions withou


Influence Of Transitional Care in Hospital Readmission Among Elderly Patients

Phase 4- Outcomes

Dania Morejon

Florida National University

Nursing Research

Professor Dr. Barry E. Graham, DNP, MSN-Ed, RN

July 17, 2021



The key purpose regarding this study is to offer an explanation as well as the right set of

exploration regarding the nature of the identified relationships between the identified early

provider follow you as well as the nursing care coordination or intensity management type of

intensity. In this phase of the assignment, sample features will be illustrated first, with the right set

of comparisons between the various groups for the readmission as well as identified EPF within a

period of 14 days. Bivariate type of correlations between the identified variables will also be

effectively presented. Finally, the identified statistical analysis outcomes regarding each of the

research objectives will be effectively addressed (Albert, 2016).



In the following study, there was the identification of the vital upstream elements which are

associated with impacting the identified provision of the identified transitional care for the

identified elderly population. Transitional type of care for the elderly people by the identified

providers as well as nurses can be effectively tailored to the identified population elements like the

identified HF disease burden as well as the upstream elements like the neighborhood disadvantage

among others. Future CCTM type of nursing research should build on these types of individual

level types of interventions as well as in the identification of the trends and even designing of the

population level types of interventions to enhance outcomes (Bergethon et al., 2016).

Sample Characteristics

Barry Graham
Title name is not needed here.


After the identified extraction of cases meeting the identified inclusion criteria from the

given primary data associated file, exclusions as well as the identified data cleaning, a final study

associated sample that was if 1280 cases was effectively attained. The identified mean age

regarding the identified subjects was considered to be 79.5 whereby half of then were female

making up 50.7% of the total demographic and 25.9% of them were of the non white race. Given

the identified inclusion criteria regarding age ≥ 65, most of the identified subjects were found to be

effectively insured by the prominent Medicare which was 94.9%. 1.6% had been insured by the

famous Medicaid while 3.6% had been insured by private insurance. The median length regarding

the hospital stay was considered to be 5 days and about 31.8% were effectively discharged with

identified home associated healthcare (DeVore et al., 2016).

The primary residences of the subject were effectively disseminated across the identified



Influence Of Transitional Care in Hospital Readmission Among Elderly Patients

Dania Morejon

Florida National University

June 12, 2021

Barry Graham
Please pay attention to your indentations, they are more than what is required.

Barry Graham
Please review the requirements for the title page.



According to mounting data, transitional care lineups can assist significant

discourse difficulties confronting health care organizations and our expanding older adult

population in many nations by lowering wasteful health service consumption. According to Weeks

et al. (2018), four case-control studies revealed that out of the 20,997 participants, whose mean age

was 76, transitional care significantly reduced hospital readmission rates at one month. Transitional

care usually has an auspicious influence on preventative care since it can increase the utilization of

primary care amenities (Weeks et al., 2018). Transitional care is an effective way of reducing

readmission or rehospitalization in the most significant merger and reducing home health

consumption. It is considered the best way o dealing with the issue of readmissions among many

adults in society.

Transitional care has some effects on hospital readmission and mortality rate in

patients with Chronic Obstructive Pulmonary Disease. Transitional care usually meaningfully

decreases the jeopardy of chronic obstructive pulmonary disease correlated readmissions (Ridwan

et al., 2019). The benefits of transitional care typically depend on the form of care providers and

the intervention period to the patients. The effects of transitional care on hospital rehospitalization

are always moderated by the period of intervention and the use of different elements for follow-up

as a way of intervening. According to the online research carried out by Ridwan et al. (2019), there

is a significant effect of transitional care on both chronic obstructive pulmonary disease and all

other causes of hospital readmission in patients with such problems.

Transitional care also has impacts on chronically ill old patients. Transitional care

for older patients with chronic disease from the hospital to primary care is complex and often result

in higher mortality and service utilization (Berre et al., 2017). Transitional care solutions are being

Barry Graham

Barry Graham

Barry Graham


Influence Of Transitional Care in Hospital Readmission Among Elderly Patients

Dania Morejon

Florida National University

July 3, 2021

Barry Graham
Please pay close attention to your similarity index. The acceptable range is anything below 20%. Thank you.

Barry Graham
Please pay attention to the requirements for APA 7th edition title page requirements. Please refer to the APA 7th edition Publication manual of consult the writing center. Thank you.


Phase 3 of the research project, known as the implementation phase, is a phase where

strategies and plans are put into action to accomplish the objectives and goals of the research.

Phase 3 of the research on the influence of transitional care interventions involves significant

activities, budget planning, scheduling time, and statistical tools for statistical analysis. Elderly

healthcare patients frequently live alone and need treatments from primary or secondary health

care and medical patients with many concurrent conditions and decreased physical or mental

functionality. The risks of adverse effects and safety issues are considered for elderly persons

with complicated comorbid illnesses soon following their hospital discharge. Unplanned

hospital readmission appears to link to inadequate release planning, spontaneous occurrences

during the release and transfer of hospital and primary care personnel, such as medication

mistakes and poor communication. On the other hand, optimized, customized, and patient-

centred disposal planning and transitions may minimize hospital residence time, readmission

risks, medicines inconsistencies, and death, enhance patients’ everyday lives, and reduce health

expenses. The implementation phase of the research on the influence of transitional care as an

intervention in hospital readmissions aims to enable examining the intervention to address

challenges facing the elderly.


The research team should pick ethical approval from the organization that is

participating. Written consent also need to be obtained from the participants who are involved

in the research. Eligible patients should register, given written permission and baseline, data

should collection take within 72 hours of admission. One of the four groups is to be

randomized: 1) ordinary care, 2) training, 3) home visits and telephone support for children (N-

HaT), or 4) home visits for nurses and phone follow-up for nurse visits (ExN-HaT). A typical

hospital with good health care monitoring provided to participants in the control group. It

Barry Graham
Not needed.

Barry Graham
Very good.

Barry Graham


should involve a required assessment by a hospital health professional, discharge planning, and

referrals to appropriate follow-up services.

Approximately two hours of evaluation and a personalized exercise program and six per

week during home visits by physiologist s

Final submission –

Pay attention to APA formatting, spelling, and grammar. Your similarity index/plagiarism score must be below 10%. Higher scores may impact your grade.

The final submission is the combination of the other four phases into one paper. You will combine Phase I, Phase II, Phase III, and Phase IV to make Phase V. You are responsible for editing and formatting your paper so that your paper will flow for the reader. This paper will need to be corrected with all the feedback provided from previous papers. Include conclusion and learning experiences from the essentials and from the class. Do not forget to document limitations and implications for future research/practice. Please review the PowerPoint prior to submitting your assignment, thank you.

Why Choose Us

  • 100% non-plagiarized Papers
  • 24/7 /365 Service Available
  • Affordable Prices
  • Any Paper, Urgency, and Subject
  • Will complete your papers in 6 hours
  • On-time Delivery
  • Money-back and Privacy guarantees
  • Unlimited Amendments upon request
  • Satisfaction guarantee

How it Works

  • Click on the “Place Order” tab at the top menu or “Order Now” icon at the bottom and a new page will appear with an order form to be filled.
  • Fill in your paper’s requirements in the "PAPER DETAILS" section.
  • Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • Click “CREATE ACCOUNT & SIGN IN” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.