College of Nursing and Health Sciences DNP Defense - Patricia Finnernan, MSN, NP-C
Project Title: Does the Standardization of the Inpatient Nurse Practitioner Role Decrease Length of Stay in Vascular Surgery Patients?
Student name: Patricia Finnernan, MSN, NP-C
Date of Defense: April 15th, 2025
Time: 4pm
Zoom: Contact dhoffman@umassd.edu for link
Faculty Mentor: Christine Saba Rezendes, DNP, AGNP-BC, ACNS-BC
Committee Members:
Kristin Gill-Bonanca DNP, MBA, RN, CCRN, NE-BC
and Virginia Capasso, PhD, CNP, CNS, FACCWS, FAAN
Abstract
Length of stay is an issue affecting healthcare systems due to fixed reimbursements based on diagnoses. While maintaining high-quality patient care, hospitals must address length of stay to avoid financial losses in this payor system. In a surgical division at a Boston-based hospital, the length of stay has increased, and a quality improvement initiative was implemented that involves a weekly huddle to address patient-specific factors contributing to length of stay. The objective of the scholarly project was to determine whether implementing a standardized service-based nurse practitioner model, compared to current team practice, decreases the length of stay. A review of the current literature suggested that length of stay may be reduced when an advanced practice provider leads multidisciplinary rounding. The scholarly project utilized Lippitt’s Seven-Step Change Theory (Lippitt, Watson, & Wesley, 1958). The project included education for current nurse practitioners on standardizing the float nurse practitioner role to decrease the length of stay. Quantitative data were obtained using a TeamSTEPPS (Agency for Healthcare Research and Quality, 2024) survey and qualitative questions to measure the nurse practitioners' perceptions of the intervention, which showed an overall favorable response. The Cronbach alpha for four of the five key areas ranged between 0.85 and 0.9. The length of stay for the cohort patients before standardizing the float role in the huddle did not decrease during the pilot period. Participating nurse practitioners identified the benefit of a standardized float role in ensuring that all patients with a prolonged length of stay are consistently presented in huddle.
Keywords: length of stay, inpatient surgical service, service-based nurse practitioner, multidisciplinary rounding
ZOOM please contact dhoffman@umassd.edu for link
: 285 Old Westport Road
Deanna Hoffman
dhoffman@umassd.edu