Date of Graduation

Spring 5-19-2016

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Dr. T Gallo


The clinical nurse leader (CNL) internship project’s purpose is to implement a change to decrease readmission for clients in a care transition program, thereby improving quality of life. This care transition program aids with the transition from hospital to home for adults. The microsystem is composed of public health nurses, volunteers, student interns, supervisors, and an administrative assistant. The aim statement for this change project is to improve patient safety by decreasing readmission rates by implementing an initial follow-up phone call within one day of discharge in 75% of the care transition clients by April 30, 2016. This project was based on research articles that stated that readmission rates were decreased with a follow-up phone call. Melton et al. (2012) state that the patients who received a follow-up phone call within one day had a “22% relative reduction in all-cause readmissions” in comparison to those who received a follow-up call within two days (p. 838). The microsystem was given education regarding the change project and streamlining the process of opening the charts. Upon evaluation of the clients referred in March and April, the clients that received a follow-up phone call within one day of discharge was 71.4%. Using the information gathered in this study, this care transition program can improve other care transition programs and thereby decrease readmission rates and increase quality of life.