Degree Name
Nursing Practice, DNP
Publication Date
6-22-2026
First Advisor
Lisa Drake
Second Advisor
Leigh Swartzendruber
Abstract
Avoidable hospitalizations from skilled nursing facilities (SNF) contribute to increased healthcare costs, resident distress, and adverse health outcomes. Many readmissions result from delays in identifying and communicating early signs of resident deterioration. The purpose of this project was to implement an evidence-based intervention to recognize early changes in residents’ conditions, empower nursing staff to detect and promptly communicate concerns, and impact 30-day hospital readmission rates. Problems identified included delayed recognition of early changes in residents’ conditions, fragmented staff communication, and the absence of standardized reporting practices, which were associated with preventable hospital readmissions. A quasi-experimental pre-/post-intervention design guided by Jean Watson’s Theory of Human Caring and Lewin’s Change Theory was implemented over 12 weeks in a SNF. Twenty-seven nursing staff completed training and were evaluated on knowledge, perceptions, and integration of the Stop and Watch Tool (SWT) into practice using the Normalization Measure Development (NoMAD) survey. Data were analyzed using descriptive and inferential statistics. Findings demonstrated a positive association between SWT implementation and improved staff understanding, engagement, and use of the tool. Overall NoMAD scores increased significantly across all domains to a post-implementation mean of 76.44 (p < .001). Hospital readmission rates decreased from 41% to 29%. This project supports the SWT as a tool that bridged the staff communication gap in reporting condition changes and impacted hospital readmission rates. Embedding the training into onboarding and performance evaluations could ensure ongoing impact.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Hicks, Lorraine, "Quality Improvement Project The Impact of the INTERACT “Stop and Watch Tool” in a Skilled Nursing Facility" (2026). Doctor of Nursing Practice Projects. 357.
https://arch.astate.edu/dnp-projects/357
