An Individualized Telephone Educational Intervention for Patients Following Coronary Artery Bypass Graft Surgery During the First Three Weeks After Discharge
An Individualized Telephone Educational Intervention for Patients Following Coronary Artery Bypass Graft Surgery During the First Three Weeks After Discharge

Author: Karen Martha Williamson

Publisher:

Published: 2007

Total Pages: 338

ISBN-13: 9780494396117

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The purpose of this randomized clinical trial was to evaluate the effectiveness of a weekly individualized, telephone, educational intervention for coronary artery bypass graft (CABG) surgical patients during the first three weeks following discharge from hospital. Orem's Theory of Self-Care guided the design of the intervention and the study. An experimental design with repeated measures was used to determine the effectiveness of the intervention on improving knowledge of symptom management and performance of therapeutic self-care behaviours, and in reducing symptom severity. Patients (N=88), undergoing their first CABG surgery, were randomly assigned to one of two groups either receiving the usual pre-discharge education or the usual predischarge education and the individualized, telephone intervention. The three educational intervention sessions focused on patients' concerns related to six post-operative symptoms (ie. pain, anxiety, depression, fatigue, sleep disturbances, and activity limitations) and related symptom management strategies were discussed. Data related to symptom severity were collected at pre-test (during hospitalization) and during each of the three weeks of the intervention implementation. Data related to knowledge of symptom management and therapeutic self-care were collected at pre-test and at post-test (week 4). Major findings from the analyses indicated that the intervention was effective in improving knowledge of symptom management and performance of therapeutic self-care behaviours, and in reducing symptom severity. Anxiety, fatigue, sleep disturbances, and activity limitations were significantly decreased in the intervention group during each of the first three weeks following discharge as compared to the control group. Pain intensity and interference, as well as depression were lower in the intervention group at weeks 2 and 3 after discharge. Moderate positive correlations were found between knowledge of symptom management and therapeutic self-care, knowledge of symptom management and the symptoms severity of pain interference, fatigue, and activity limitations, as well as with therapeutic self-care and the severity of all symptoms except for pain intensity. Age was negatively moderately correlated with knowledge of symptom management. Some of the implications from the study findings are related to examining the long-term effectiveness of the intervention and evaluating the feasibility of implementing the intervention in a hospital-based setting.

ACCCN's Critical Care Nursing
ACCCN's Critical Care Nursing

Author: Leanne Aitken

Publisher: Elsevier Health Sciences

Published: 2016-01-04

Total Pages: 1051

ISBN-13: 0729542009

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With each edition, ACCCN's Critical Care Nursing has built on its highly respected reputation. Its contributors aim to encourage and challenge practising critical care nurses and students to develop world-class critical care nursing skills in order to ensure delivery of the highest quality care. Endorsed by the Australian College of Critical Care Nurses (ACCCN), this 3rd edition presents the expertise of foremost critical care leaders and features the most recent evidence-based research and up-to-date advances in clinical practice, technology, procedures and standards. Expanded to reflect the universal core elements of critical care nursing practice authors, Aitken, Marshall and Chaboyer, have retained the specific information that captures the unique elements of contemporary critical care nursing in Australia, New Zealand and other similar practice environments. Structured in three sections, ACCCN's Critical Care Nursing, 3rd Edition addresses all aspects of critical care nursing, including patient care and organisational issues, while highlighting some of the unique and complex aspects of specialty critical care nursing practice, such as paediatric considerations, trauma management and organ donation. Presented in three sections: - Scope of Critical Care - Principles and Practice of Critical Care - Speciality Practice Focus on concepts that underpin practice - essential physical, psychological, social and cultural care New case studies elaborate on relevant care topics Research vignettes explore a range of topics Practice tips highlight areas of care particularly relevant to daily clinical practice Learning activities support knowledge, reflective learning and understanding Additional case studies with answers available on evolve NEW chapter on Postanaesthesia recovery Revised coverage of metabolic and nutritional considerations for the critically ill patient Aligned with the NEW ACCCN Standards for Practice

ACCCN's Critical Care Nursing - E-Book
ACCCN's Critical Care Nursing - E-Book

Author: Leanne Aitken

Publisher: Elsevier Health Sciences

Published: 2015-10-01

Total Pages: 1051

ISBN-13: 0729583368

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With each edition, ACCCN’s Critical Care Nursing has built on its highly respected reputation. Its contributors aim to encourage and challenge practising critical care nurses and students to develop world-class critical care nursing skills in order to ensure delivery of the highest quality care. Endorsed by the Australian College of Critical Care Nurses (ACCCN), this 3rd edition presents the expertise of foremost critical care leaders and features the most recent evidence-based research and up-to-date advances in clinical practice, technology, procedures and standards. Expanded to reflect the universal core elements of critical care nursing practice authors, Aitken, Marshall and Chaboyer, have retained the specific information that captures the unique elements of contemporary critical care nursing in Australia, New Zealand and other similar practice environments. Structured in three sections, ACCCN’s Critical Care Nursing, 3e addresses all aspects of critical care nursing, including patient care and organisational issues, while highlighting some of the unique and complex aspects of specialty critical care nursing practice, such as paediatric considerations, trauma management and organ donation. Presented in three sections: - Scope of Critical Care - Principles and Practice of Critical Care - Speciality Practice Focus on concepts that underpin practice - essential physical, psychological, social and cultural care New case studies elaborate on relevant care issues Practice tips highlight areas of care particularly relevant to daily clinical practice Learning activities support knowledge, reflective learning and understanding Additional case studies with answers available on evolve NEW chapter on Postanaesthesia recovery Revised coverage of metabolic and nutritional considerations for the critically ill patient Aligned with the NEW ACCCN Standards for Practice

Distance Education
Distance Education

Author: Judith L. Johnson

Publisher: Teachers College Press

Published: 2003

Total Pages: 244

ISBN-13: 9780807743737

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Johnson continues her extensive research with case studies of some of the world's standout examples of distance education. Topics include pedagogy, student support services, design and delivery of programs, issues of assessment, evaluation, accreditation, and emerging technology standards.

Guidelines for Clinical Practice
Guidelines for Clinical Practice

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1992-02-01

Total Pages: 441

ISBN-13: 0309045894

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Guidelines for the clinical practice of medicine have been proposed as the solution to the whole range of current health care problems. This new book presents the first balanced and highly practical view of guidelinesâ€"their strengths, their limitations, and how they can be used most effectively to benefit health care. The volume offers: Recommendations and a proposed framework for strengthening development and use of guidelines. Numerous examples of guidelines. A ready-to-use instrument for assessing the soundness of guidelines. Six case studies exploring issues involved when practitioners use guidelines on a daily basis. With a real-world outlook, the volume reviews efforts by agencies and organizations to disseminate guidelines and examines how well guidelines are functioningâ€"exploring issues such as patient information, liability, costs, computerization, and the adaptation of national guidelines to local needs.

The ESC Textbook of Preventive Cardiology
The ESC Textbook of Preventive Cardiology

Author: Stephan Gielen

Publisher: European Society of Cardiology

Published: 2015

Total Pages: 369

ISBN-13: 0199656657

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"EACPR, European Association for Cardiovascular Prevention and Rehabilitation -- European Society of Cardiology."

The Effect of Telehealth on 30-Day Readmissions in Medicare Beneficiaries Following Isolated Coronary Artery Bypass Graft Surgery
The Effect of Telehealth on 30-Day Readmissions in Medicare Beneficiaries Following Isolated Coronary Artery Bypass Graft Surgery

Author: Kathleen Shaughnessy

Publisher:

Published: 2018

Total Pages: 174

ISBN-13:

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Cardiovascular disease (CVD) is the leading cause of death in 45.1% of Americans. Each year in the United States, 790,000 suffer myocardial infarction as end organ damage from coronary disease. Coronary artery bypass graft (CABG) surgery is a life-saving procedure for many patients with severe coronary artery disease. However, hospital readmissions for complications within 30 days after CABG discharge pose substantial burden to patients, families, and the healthcare system. This scholarly project examined the effect of a telehealth (TH) program in addition to usual discharge care on 30-day readmissions in Medicare isolated CABG patients. A retrospective case-controlled analysis of TH program data was conducted at a single project site. Medicare patients who participated in a TH program after discharge to a home setting following isolated CABG surgery from 5/1/17-4/30/18 were compared with a causal comparison group receiving usual care from 5/1/16-4/30/17. A total of 83 cases (51 control; 32 treatment) met inclusion criteria. No statistically significant differences were noted in 30-day all cause readmission (p=0.568), emergency room encounters (p=0.785) or readmissions specifically related to atrial fibrillation, heart failure, or pleural effusion. The treatment group showed a trend toward timely follow-up to cardiology appointments, with a reduction from 19.8 to 13.7 days (p= 0.062). The treatment group experienced no failures to show for surgical follow-up appointments. Treatment interventions due to TH primarily consisted of medication initiation and titration. Therefore, one practice recommendation is to incorporate a diuretic script into the discharge plan with instructions for use. A second recommendation is to remove barriers to surgical follow-up by utilizing nurse practitioners to evaluate these postoperative patients within one week of discharge. A final recommendation is to evaluate best practices for discharge care post isolated CABG surgery for incorporation into the American Hospital Association (AHA)/American College of Cardiology (ACC) guidelines. Reducing hospital readmissions from siloed care represents an opportunity to reduce cost and improve transitions of care practices.