Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences



Major Advisor

Kathy Hager

Second Advisor

Linda Mefford


The purpose of this clinical quality improvement project was to determine if using the Stop and Watch tool (a tool used to identify change in resident condition) would improve communication between stakeholders and nurses, resulting in fewer re-hospitalizations. The evidence-based literature behind the problem of re-hospitalization shows that improving communication among stakeholders can positively affect long term care residents’ quality of life and decrease events that could result in re-hospitalizations.

The design for this study includes process development on the use of the Stop and Watch tool (a communication component of the Intervention to Reduce Acute Care Transfers tool [INTERACT ®] Quality Improvement Program) to improve stakeholder communication, as well as data analyses on re-hospitalization rates, specifically determining if re-hospitalization was avoidable or un-avoidable. The studied facility administrator suggested addressing four conditions that they had identified as the major conditions for which past residents had been re-hospitalized (heart failure, respiratory distress, memory impairment, and residents at high risk for falls). Stakeholders were trained on how to use the tool for ten minute one-on-one sessions by an INTERACT ® Champion and during new hire orientation by a registered nurse educator. All stakeholders were encouraged to use the tool every shift when acute changes in condition were noted; the tool was monitored on how often it was used.

Included in

Nursing Commons