DIABETIC RESEARCH PROPOSAL 1
WGU D155 | READMISSIONS AMONG ADULTS WITH TYPE 2
DIABETES | LATEST UPDATE WITH COMPLETE SOLUTIONS
Research Proposal: RN-Led Case Management and 30-Day Hospital
Readmissions Among Adults with Type 2 Diabetes
Vicki Thompson
School of Nursing, Liberty University
Author Note
I have no known conflict of interest to disclose. Correspondence concerning this article should
be addressed to Vicki Thompson. Email:
,DIABETIC RESEARCH PROPOSAL 2
Research Proposal
Background and Significance
Hospital readmissions remain an important concern for patients, families, healthcare
organizations, and the nursing profession. A hospital readmission can increase healthcare
utilization and costs while also placing additional physical and emotional demands on patients
and their families. The transition from an acute care setting to the home is particularly important
because patients are expected to understand new or changed medications, follow treatment
recommendations, recognize complications, and arrange follow-up care after discharge. For
adults with Type 2 diabetes mellitus, these responsibilities can be especially challenging because
effective diabetes management requires continued attention to medications, blood glucose
monitoring, nutrition, physical activity, symptom recognition, and healthcare follow-up.
The transition from hospitalization to home can create opportunities for gaps in care.
Patients may receive medication changes, new prescriptions, or complex discharge instructions
that are difficult to understand or implement. Other barriers may include medication
affordability, transportation problems, limited access to primary care, health literacy, food
insecurity, and limited social support. These factors may influence a patient's ability to follow
the discharge plan and may contribute to emergency department visits or hospital readmission.
Research examining readmissions among adults with diabetes has identified multiple clinical and
demographic factors associated with readmission risk, demonstrating that readmission is a
complex outcome rather than one caused by a single factor (Soh et al., 2020; Timple & Kawar,
2022).
,DIABETIC RESEARCH PROPOSAL 3
Transitional care and care coordination are potential strategies for addressing challenges
that occur during the transition from hospital to home. Evidence summarized in the literature
review matrix indicates that effective transitional care may include medication reconciliation,
patient education, communication among healthcare providers, individualized discharge
planning, and registered nurse care coordination. Burke et al. (2013) identified these components
as important elements of an effective transition-of-care process. Similarly, evidence from
randomized controlled trials has demonstrated benefits associated with nurse-led transitional care
and structured discharge interventions (Coleman et al., 2006; Jack et al., 2009).
Nurses are well positioned to provide transitional support because nursing practice
includes patient assessment, education, discharge planning, communication, care coordination,
and chronic disease management. An RN-led case management intervention can begin before
discharge and continue after the patient returns home. The proposed intervention will include
standardized diabetes self-management education, medication reconciliation and education,
assessment of barriers to care, assistance with follow-up appointments, communication with
healthcare providers, and post discharge telephone follow-up. These components are consistent
with evidence supporting multicomponent transitional-care interventions (Hansen et al., 2011;
Leppin et al., 2014).
This research is significant to nursing because nurses have a direct role in helping
patients manage chronic illness and navigate transitions between healthcare settings. Research
evaluating an RN-led intervention specifically among adults with Type 2 diabetes may provide
additional evidence regarding how nursing care coordination can be used to address post
discharge needs. The proposed study will examine 30-day all-cause hospital readmission as the
primary outcome while also evaluating diabetes knowledge, medication adherence, follow-up
, DIABETIC RESEARCH PROPOSAL 4
appointment attendance, and HbA1c as secondary outcomes. The study is therefore designed to
evaluate not only whether readmission differs between groups but also whether the intervention
is associated with measurable changes in behaviors and clinical indicators related to diabetes
self-management.
Research Problem
Adults with Type 2 diabetes may experience challenges managing their condition
following hospitalization, particularly when discharge involves medication changes, new self-
management responsibilities, and the need for timely outpatient follow-up. Although transitional-
care interventions have been studied extensively, evidence varies according to the patient
population, intervention components, healthcare setting, and outcomes measured. Much of the
foundational transitional-care literature has focused on broad hospitalized populations or chronic
conditions such as heart failure rather than specifically examining adults with Type 2 diabetes
receiving a standardized RN-led case management intervention.
The problem addressed by this study is the need for additional evidence regarding
whether a structured RN-led case management and care coordination intervention can improve
post discharge outcomes among adults with Type 2 diabetes. The proposed study will address
this problem by comparing patients receiving standardized intervention with patients receiving
usual discharge care within the same acute care setting.
Purpose of the Study
The purpose of this quantitative study is to determine whether a standardized RN-led case
management and care coordination intervention is associated with a lower rate of all-cause hospital
readmission within 30 days of discharge among adults with Type 2 diabetes. Secondary outcomes
will include diabetes self-management knowledge, medication adherence, follow-up appointment
WGU D155 | READMISSIONS AMONG ADULTS WITH TYPE 2
DIABETES | LATEST UPDATE WITH COMPLETE SOLUTIONS
Research Proposal: RN-Led Case Management and 30-Day Hospital
Readmissions Among Adults with Type 2 Diabetes
Vicki Thompson
School of Nursing, Liberty University
Author Note
I have no known conflict of interest to disclose. Correspondence concerning this article should
be addressed to Vicki Thompson. Email:
,DIABETIC RESEARCH PROPOSAL 2
Research Proposal
Background and Significance
Hospital readmissions remain an important concern for patients, families, healthcare
organizations, and the nursing profession. A hospital readmission can increase healthcare
utilization and costs while also placing additional physical and emotional demands on patients
and their families. The transition from an acute care setting to the home is particularly important
because patients are expected to understand new or changed medications, follow treatment
recommendations, recognize complications, and arrange follow-up care after discharge. For
adults with Type 2 diabetes mellitus, these responsibilities can be especially challenging because
effective diabetes management requires continued attention to medications, blood glucose
monitoring, nutrition, physical activity, symptom recognition, and healthcare follow-up.
The transition from hospitalization to home can create opportunities for gaps in care.
Patients may receive medication changes, new prescriptions, or complex discharge instructions
that are difficult to understand or implement. Other barriers may include medication
affordability, transportation problems, limited access to primary care, health literacy, food
insecurity, and limited social support. These factors may influence a patient's ability to follow
the discharge plan and may contribute to emergency department visits or hospital readmission.
Research examining readmissions among adults with diabetes has identified multiple clinical and
demographic factors associated with readmission risk, demonstrating that readmission is a
complex outcome rather than one caused by a single factor (Soh et al., 2020; Timple & Kawar,
2022).
,DIABETIC RESEARCH PROPOSAL 3
Transitional care and care coordination are potential strategies for addressing challenges
that occur during the transition from hospital to home. Evidence summarized in the literature
review matrix indicates that effective transitional care may include medication reconciliation,
patient education, communication among healthcare providers, individualized discharge
planning, and registered nurse care coordination. Burke et al. (2013) identified these components
as important elements of an effective transition-of-care process. Similarly, evidence from
randomized controlled trials has demonstrated benefits associated with nurse-led transitional care
and structured discharge interventions (Coleman et al., 2006; Jack et al., 2009).
Nurses are well positioned to provide transitional support because nursing practice
includes patient assessment, education, discharge planning, communication, care coordination,
and chronic disease management. An RN-led case management intervention can begin before
discharge and continue after the patient returns home. The proposed intervention will include
standardized diabetes self-management education, medication reconciliation and education,
assessment of barriers to care, assistance with follow-up appointments, communication with
healthcare providers, and post discharge telephone follow-up. These components are consistent
with evidence supporting multicomponent transitional-care interventions (Hansen et al., 2011;
Leppin et al., 2014).
This research is significant to nursing because nurses have a direct role in helping
patients manage chronic illness and navigate transitions between healthcare settings. Research
evaluating an RN-led intervention specifically among adults with Type 2 diabetes may provide
additional evidence regarding how nursing care coordination can be used to address post
discharge needs. The proposed study will examine 30-day all-cause hospital readmission as the
primary outcome while also evaluating diabetes knowledge, medication adherence, follow-up
, DIABETIC RESEARCH PROPOSAL 4
appointment attendance, and HbA1c as secondary outcomes. The study is therefore designed to
evaluate not only whether readmission differs between groups but also whether the intervention
is associated with measurable changes in behaviors and clinical indicators related to diabetes
self-management.
Research Problem
Adults with Type 2 diabetes may experience challenges managing their condition
following hospitalization, particularly when discharge involves medication changes, new self-
management responsibilities, and the need for timely outpatient follow-up. Although transitional-
care interventions have been studied extensively, evidence varies according to the patient
population, intervention components, healthcare setting, and outcomes measured. Much of the
foundational transitional-care literature has focused on broad hospitalized populations or chronic
conditions such as heart failure rather than specifically examining adults with Type 2 diabetes
receiving a standardized RN-led case management intervention.
The problem addressed by this study is the need for additional evidence regarding
whether a structured RN-led case management and care coordination intervention can improve
post discharge outcomes among adults with Type 2 diabetes. The proposed study will address
this problem by comparing patients receiving standardized intervention with patients receiving
usual discharge care within the same acute care setting.
Purpose of the Study
The purpose of this quantitative study is to determine whether a standardized RN-led case
management and care coordination intervention is associated with a lower rate of all-cause hospital
readmission within 30 days of discharge among adults with Type 2 diabetes. Secondary outcomes
will include diabetes self-management knowledge, medication adherence, follow-up appointment
