Graduation Year


Degree Type

Open Access Capstone

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



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Baccalaureate and Graduate Nursing

First Advisor

Jill Cornelison

Department Affiliation

Baccalaureate and Graduate Nursing

Second Advisor

Gina L. Purdue

Department Affiliation

Baccalaureate and Graduate Nursing


This paper explores the use of the Coleman Transition Model as an evidenced based intervention to reduce 30-day readmissions of Chronic Obstructive Pulmonary Disease (COPD) patients on a pulmonary unit. Nearly 20% of Medicare beneficiaries are re-hospitalized within 30 days after discharge, resulting in an annual cost of approximately $17 billion. Hospitals can engage in activities to lower their rate of readmissions. The evidenced based intervention includes robust case management using The Coleman Transition Model in hospitalized COPD patients to reduce readmissions. COPD is a prevalent, complex, and costly condition to manage. COPD is now the third leading cause of death in the United States. Multiple studies were compared to determine if integrated care models that include readmission risk stratification and case management improve the quality of care provided to the COPD population and decreased all cause 30-day readmissions to the acute care setting by providing standardized education, coordinated discharge planning and follow-up.

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