Other Titles
Rising Star Poster/Presentation
Abstract
Hospital readmission rate is highest among underserved communities. Providing continuum of care to these populations will yield a greater reduction in readmission rate. Church and faith-based clinics often help underserved communities. Equipping them with the transitional care model (TCM) and an Advanced Practice Registered Nurse (APRN) with specialized training as a Faith Community Nurse (FCN) can implement whole-person care and reduce hospital readmission and improve the health of the community. Monterey County has a readmission rate of 13.4%. Only one out of four community hospitals has a transitional care department only for diagnoses specified in the Hospital Readmissions Reduction Program (HRRP). The Project Lead offered an educational session to the 17 health ministry members, church leaders, and other stakeholders of the local community church in Monterey County, Salinas, California. The session introduced the Health Ministry Association, history and philosophy of health ministry, examples of spiritual care, and covered key concepts such as FCN, TCM, and whole-person care. An anonymous survey assessed participants’ demography and overall satisfaction with the educational offering. A knowledge assessment tool, created by Dr. Ziebarth, an expert in faith community nursing and transitional care was given before and after the educational offering. The pre-test results were used as a baseline, and the post-test results assessed how much the participants attained knowledge.
The project anticipated a 20% increase in knowledge and a post-intervention pass rate of 80%. Scores less than 80% were remediated by reviewing the contents and allowing the participants to retake the test. After the educational session, 15 participants completed the pre- and post-test. The one-tail t-test result was 0.0023 (p-value set to 0.05), which was significant even before the remediation of the seven people who scored below 80%. After remediation, the one-tail t-test result was 0.0001.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Pilot/Exploratory Study
Keywords:
Readmission Rates, Transitional Care, Faith-based Care, Nurse-led Transitional Care, Nurse Practitioner, Health Ministry, Community Nursing
Recommended Citation
Cummings, Youn Kyeong; Chaudhary, Victoria; Knighten, Mary Lynn; Ziebarth, Deborah J.; and Shiah, Sang Ah, "Faith-Based Transitional Care Model (TCM) Clinic: Pilot Project" (2025). International Nursing Research Congress (INRC). 196.
https://www.sigmarepository.org/inrc/2025/posters_2025/196
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Faith-Based Transitional Care Model (TCM) Clinic: Pilot Project
Seattle, Washington, USA
Hospital readmission rate is highest among underserved communities. Providing continuum of care to these populations will yield a greater reduction in readmission rate. Church and faith-based clinics often help underserved communities. Equipping them with the transitional care model (TCM) and an Advanced Practice Registered Nurse (APRN) with specialized training as a Faith Community Nurse (FCN) can implement whole-person care and reduce hospital readmission and improve the health of the community. Monterey County has a readmission rate of 13.4%. Only one out of four community hospitals has a transitional care department only for diagnoses specified in the Hospital Readmissions Reduction Program (HRRP). The Project Lead offered an educational session to the 17 health ministry members, church leaders, and other stakeholders of the local community church in Monterey County, Salinas, California. The session introduced the Health Ministry Association, history and philosophy of health ministry, examples of spiritual care, and covered key concepts such as FCN, TCM, and whole-person care. An anonymous survey assessed participants’ demography and overall satisfaction with the educational offering. A knowledge assessment tool, created by Dr. Ziebarth, an expert in faith community nursing and transitional care was given before and after the educational offering. The pre-test results were used as a baseline, and the post-test results assessed how much the participants attained knowledge.
The project anticipated a 20% increase in knowledge and a post-intervention pass rate of 80%. Scores less than 80% were remediated by reviewing the contents and allowing the participants to retake the test. After the educational session, 15 participants completed the pre- and post-test. The one-tail t-test result was 0.0023 (p-value set to 0.05), which was significant even before the remediation of the seven people who scored below 80%. After remediation, the one-tail t-test result was 0.0001.
Description
All 15 participants understood the concept of FCN TCM and demonstrated knowledge attainment by passing the test. The volunteer and church leader's knowledge attainment successfully established the foundation of the Faith Community Nurse Transitional Care Program at the community church in Salinas, California.