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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Kay Foland


This is a DNP project implemented in an assisted-living facility in the Midwest. The emphasis of the project is to utilize the Probability of Repeated Admission (Pra) instrument to identify assisted-living facility (ALF) residents at risk for hospitalization. The Pra score has been shown to be useful in identifying elders who are at risk for hospitalization. In addition to this, a tool called the Stop, Watch, and Tell tool was utilized for staff to report a concerning symptom in an ALF resident. The Stop, Watch, and Tell tool was adapted from the Stop and Watch tool within the INTERACT program. Review of the literature showed a decline in hospitalizations when the INTERACT program was utilized. Staff utilized the Stop, Watch, and Tell tool to report changes in a resident to nursing staff. Nursing staff had the opportunity to intervene early in an effort to avoid a decline in health status and need for hospitalization or emergency room care. Select portions of the INTERACT program were also used, but INTERACT as a whole was not implemented. The project did not achieve statistical significance in relationship to hospitalization rates. However, clinical significance was achieved. Staff of the assisted-living facility did formally report concerns they noted in ALF residents. Nursing staff followed up on the reported concerns and residents received care sooner or received care when they may have not otherwise received care.

Library of Congress Subject Headings

Older people -- Health risk assessment
Older people -- Care
Congregate housing -- Management
Life care communities -- Management
Hospital utilization


Includes bibliographical references (pages 51-55)



Number of Pages



South Dakota State University


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