Date of Award

8-2026

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

Degree Discipline

Nursing Practice

Abstract

Hospital readmissions within 30 days following urologic surgeries are often associated with catheter complications, infections, poor pain management, and limited patient understanding of discharge instructions and therefore represent a significant quality and safety concern for patients and institutions alike. The purpose of this quality improvement project was to evaluate whether implementing structured, nurse-led telephone follow-up in conjunction with standard discharge education reduced unplanned 30-day hospital readmissions among adult patients undergoing urologic surgery. Guided by the Logic Model framework, this project used a quasi-experimental, two-group pre- and post-intervention design to compare outcomes at a high-volume outpatient urology clinic in Houston, Texas. Adult patients aged 18 to 93 years undergoing urologic surgery in the operating room were included. Nurses used a scripted assessment of pain, catheter status, infection symptoms, hydration, medication adherence, and follow-up care to assess patient status following surgery. Data were collected via retrospective chart review and prospective nurse documentation, and readmission outcomes were tracked through the electronic medical record and documented on an encrypted Excel spreadsheet. Data analysis included descriptive statistics and chi-square testing to compare readmission rates.

A total of 436 patients were included in the pre-intervention group and 524 patients in the post-intervention group. The overall 30-day readmission rate decreased from 11.24% in the pre-intervention group to 9.16% in the post-intervention group. Among the 362 patients who successfully received the nurse-led telephone follow-up intervention, the readmission rate was 9.67%. However, chi-square analysis demonstrated that the reduction in readmissions was not statistically significant, χ²(1) = 0.52, p = .472, with a very small effect size (Cohen's h = 0.0513). Despite the lack of statistical significance, the intervention improved patient engagement, reinforced discharge education, and supported early identification of postoperative concerns.

The findings of this project have implications for postoperative transitional care and support the broader role of nurses in improving continuity of care among high-risk surgical populations. Nurse-led telephone follow-up represents a feasible and sustainable strategy that may be most effective when incorporated into multifaceted transitional care interventions designed to improve patient outcomes and reduce healthcare utilization.

Keywords: nurse-led telephone follow-up, post-discharge education, quality improvement, readmission prevention, urologic surgery

Committee Chair/Advisor

Chloe Gaines

Committee Member

Sharisse Herbert

Committee Member

Ulanda Adair-Simpson

Committee Member

Brenda Campbell

Publisher

Prairie View A&M University

Rights

© 2021 Prairie View A & M University

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Date of Digitization

8/6/2026

Contributing Institution

John B Coleman Library

City of Publication

Prairie View

MIME Type

Application/PDF

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