Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Christopher P Weidlich


Carol Carver


Purpose: Assess risk of readmission of adolescent patients to an inpatient psychiatric unit within 30-days post-discharge by using a clinician-rated behavioral health outcome assessment measure to rate psychiatric patient. Background: In the United States, approximately four million adolescents suffer from mental disorders. When admitted for inpatient psychiatric care, approximately 13% of adolescent mental health patients are readmitted within 30-days, 25% within one year, and 81% within 90-days, of inpatient psychiatric admission. Methods: An evidence-based quality improvement project that utilized the clinician-rated behavioral health outcome assessment tool called the Health of the Nation Outcome Scale for Children and Adolescent (HoNOSCA). The HoNOSCA measures emotional, personal, physical, social and behavioral problems associated with mental illness in children and adolescent. Data on 168 adolescent patients at a children’s’ mental health hospital in South Texas were assessed from February 1, 2018 to March 31, 2018. Outcomes: Following assessment, the 30-day readmission rate for patients admitted in February and March 2018, decreased to 8.3% and 9.3% respectively, from a six month assessment average of 10%. Also, 100% of the registered nurses were trained on using the assessment measure, 80% of admissions were screened, and 50% of patients’ scores were reviewed. Implications for Nursing: Assessing and identifying patients’ readmission risks can help to reduce recurring readmissions and the HoNOSCA is a valid assessment tool suited to assess the type and severity of psychiatric impairment in adolescents that may cause frequent readmissions.

Keywords: HoNOSCA; Risk of readmission