护士主导的心脏康复护理协调计划:通过自动转诊和有效的护理协调,改善患者的功能结果
Kristi Boggess1, Emily Hayes, Mary Lizzie Duffy
1Author Affiliations: The University of Tennessee Medical Center, Knoxville (Ms Boggess and Dr McKeon); Heart Lung Vascular Institute, The University of Tennessee Medical Center, Knoxville (Mss Hayes and Duffy); Patient Care Pathways, The University of Tennessee Medical Center, Knoxville (Mr Indranoi); and Cardiovascular and Pulmonary Rehabilitation, The University of Tennessee Medical Center, Knoxville (Mr Sorey). The University of Tennessee Medical Center, Knoxville (Ms Blaine).
自动心脏康复 (CR) 转诊和护士协调改善了患者的治疗结果. 这种干预措施缩短了CR第二阶段招生和完成的时间,提高了患者的准备和计划的成功.
科学领域:
- 心脏病学 心脏病学
- 康复医学 康复医学 康复医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心脏康复 (CR) 对于心脏事件后的恢复至关重要.
- 优化从住院护理 (第一阶段) 到门诊CR (第二阶段) 的过渡对于患者的治疗结果至关重要.
- 当前的转介流程可能会对及时的CR入学构成障碍.
研究的目的:
- 评估自动化CR转诊和护士护理协调对患者和计划结果的影响.
- 为了比较CR第二阶段的入学和完成的身体和心理功能.
- 评估接受面对面与基于电话的护士协调的住院患者的CR参与率和完成率.
主要方法:
- 回溯式的干预前/后描述性设计.
- 具有匹配临床特征的患者的有目的抽样.
- 从电子病历,遥测和CR推工具中提取的数据,包括功能能力 (6分钟步行测试,METs) 和心理评估 (PHQ).
主要成果:
- 干预后组 (自动推/护士协调) 显示出更短的退院到CR2阶段入学 (35天而不是41天) 的趋势.
- 在干预后的组中,需要显著减少CR会话才能完成程序.
- 两组都包括52名患者,平均年龄为64岁,男性为68%,常见诊断包括CABG,MI和PCI.
结论:
- 自动化CR转诊和护士护理协调简化了从CR第一阶段到第二阶段的过渡.
- 患者在身体和心理上更好地为更早的CR第二阶段注册做好了准备.
- 干预导致在较短的时间内成功完成CR.
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