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Reducing Readmissions Due to Hyponatremia on L6

A RITE Project

Goal: To reduce readmissions for transphenoidal pituitary surgeries due to hyponatremia on L6

Submitted by Jacob Drown, BSN, RN, CNML, PCM of L6 Neurosurgery AAU


Through SHC’s Realizing Improvement Through Team Empowerment (RITE) Program, an interdisciplinary committee was formed with the goal of reducing the readmission rates of patients after transsphenoidal pituitary surgeries due to hyponatremia. Streamlining the patient journey from outpatient to inpatient to outpatient follow up, the committee performed a detailed chart review of surgical data and implemented interventions at the nursing, advanced practice provider, provider, and clinic level.


Inpatient nurses were given an in depth education on the pathophysiology of pituitary surgeries and rationales for their nursing interventions related to the surgery, focusing on the importance for strict intake and output measurements and the new guidelines for monitoring for complications of diabetes insipidus. In addition to the education, the L6 nurses began distributing a pituitary surgery discharge kit and educating patients on how to continue close monitoring of their intake and output at home and to present at their follow up appointment. 


Khristine Vinluan, MS, RN, CNL, L6 Clinical Nurse IV

This interdisciplinary team effort included several key participants:

  • Julia Chang, MD (Endocrine Attending, Team Leader)
  • Juan Fernandez Miranda, MD (Neurosurgery Attending)

  • Erin Wipff, NP (NSGY Outpatient NP)

  • Victoria Gates-Bazarbay (NSGY Outpatient NP)

  • Olivia Chu, NP (Endocrine Outpatient NP)

  • Shelli Chittum, NP (NSGY Inpatient NP)

  • Khristine Vinluan, MS, RN, CNL, Clinical Nurse IV (NSGY Inpatient RN)

The Successful Outcome

In 2021 L6 had an 8% readmission rate due to hyponatremia. This RITE project's overall goal was a less than 5% readmission rate. However, since implementing the interventions L6 has had only one readmission due to hyponatremia in April. With a current readmit readmit of 2.44%, L6 is still successfully meeting their goal.


Kudos to this interprofessional team for a successful project that improved care coordination and quality of care for their patients!

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