Date of Award
Project Team Faculty Member
Dr. Kay Gaehle
Project Team Faculty Member
Dr. Lisa Green
dyspnea, OASIS, home health
In home health patients, dyspnea is one of the quality indicators on the Medicare Outcome and Assessment Information Set (OASIS). Any home health agency that is seeking Medicare certification is required to meet Medicare Conditions of Participation, including compliance with OASIS data collection and transmission of data (Centers for Medicare and Medicaid Services, 2012). At a hospital affiliated home health agency in the Midwest, between November 2015 and October 2016, 82.85% of patients admitted for services received Medicare coverage (Memorial Home Services, 2016). Due to the high Medicare population seen by this home health agency, it is important to show improvement in dyspnea scores in their OASIS data. Between July 1, 2015 and June 30, 2016, 64.1% of patients’ dyspnea improved at the home health agency. This was compared to a state average of 72% and a national average of 71.1% (Centers for Medicare and Medicaid Services, 2017).
This evidence-based practice quality improvement study took place between August-October 2017. The primary purpose of this project was to measure improvement in nurse dyspnea scores with OASIS #M1400 before and after home health nurse education. Additional measurements included: 1) patients’ admission and discharge perception of dyspnea and comparing for significant differences between this and home health providers’ objective assessment of dyspnea and 2) evaluating the home health providers’ knowledge and correct utilization of OASIS question #M1400.
Overall, improvement in dyspnea scores using OASIS #M1400 increased by 14.6%. From September-December 2016, 73.5% of patients at the home health agency showed an improvement in dyspnea. This was compared to a state average of 77.4% and a National average of 77.0% (Centers for Medicare and Medicaid Services, 2016). Provider education was given on August 2-3, 2017. From September-December 2017, 84.2% of patients at the home health agency showed an improvement in dyspnea. This was compared to a state average of 72.7% and a National average of 73.1% (Centers for Medicare and Medicaid Services, 2017).
Findings of this project hold clinical significance as to the effectiveness of dyspnea assessment education. Future projects can be aimed at providing education at multiple agencies to test for consistency of results obtained from this project. Future projects should also be conducted over a longer period of time to ensure that improvement in dyspnea is maintained over time.
Gough, Teresa and Ozyurt, Nevin, "Effect of Nurse-Developed Dyspnea Improvement Education on Home Health Patients" (2018). Doctor of Nursing Practice Projects. 116.
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Evaluation of Results