A Novel Nesting Protocol to Decrease Readmission and Increase Patient Satisfaction Following Congenital Heart Surgery

Area of Science:

• Pediatric cardiac surgery care
• Quality improvement in healthcare
• Caregiver education and support

Background:

• Pediatric patients post-cardiac surgery require extensive caregiver education for successful hospital-to-home transition.
• Complex care needs and skill competency are crucial for managing children with congenital heart disease (CHD) after discharge.
• Caregiver understanding and preparedness significantly impact patient outcomes and readmission rates.

Purpose of the Study:

• To implement a nesting protocol in the cardiovascular intensive care unit (CVICU).
• To enhance discharge teaching and care coordination for pediatric cardiac surgery patients.
• To reduce readmission rates and improve caregiver satisfaction and understanding.

Main Methods:

• Developed and implemented a nesting protocol with clear guidelines for the multidisciplinary team.
• Collected pre- and post-intervention data using caregiver satisfaction surveys (Likert scale).
• Evaluated readmission data through retrospective chart reviews for 2016 and partial 2017.

Main Results:

• Caregiver satisfaction and understanding of the nesting process increased by 4.48% post-intervention.
• Readmission rates did not show improvement between 2016 and 2017, with only six months of 2017 data reviewed.
• Pre-intervention data indicated caregiver deficiencies in understanding care regimens, infection control, and nutrition.

Conclusions:

• Readmission remains a significant challenge for children with complex CHD.
• Effective post-discharge care hinges on caregivers' comprehensive understanding of medical requirements.
• The developed protocol aimed to address discharge readiness issues, including care regimens, infection control, and nutrition.