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Saturday, 29 October 2011
Learning Objective 1: The learner will be able to identify the impact of a nurse led telehealth intervention for elderly patients at high risk for readmission
Learning Objective 2: The learner will be able to explain differences in patient outcomes related to hospital readmissions after a nurse led telephone and telehealth intervention
Coronary artery bypass surgery is the most frequently performed surgery for coronary heart disease in the United States, with majority (54%), performed in patients > age 65. These patients are at increased risk for developing postoperative complications due to advanced disease, impaired cardiac status, and comorbidities. This poster reports on the results of a study which tested the effects of a Discharge Intervention for Cardiac Elderly (DICE) for patients > age 65 on hospital readmissions and emergency room (ER) visits within 30 days after discharge. A 3 group randomized design was used and subjects were randomized to either the DICE intervention, which consisted of home telemonitoring of twice daily vital signs including heart rate, blood pressure and pulse oximetry and daily weight, focused reinforcement of the discharge plan with advanced practice nurse telephone follow up on the day of discharge, day 3 after discharge and weekly for 4 weeks; Modified DICE, which consisted of the same telephone intervention, and Control, with no post discharge follow up. The AvidCare telehealth monitoring system was used and was installed in the patients home on the day of or day after discharge. Two-hundred-four subjects from 4 hospitals were enrolled in the study. Patients ranged in age from 65 to 92 (mean age 73). There were no differences in demographics, length of stay or hospital related characteristics between the groups. Elderly female patients (aged 75 and older) who received the telehealth intervention had less hospital readmissions and ER visits compared to telephone and control groups. In addition, patients with a higher severity of illness, as measured by the Acute Physiology and Health Evaluation (APACHE II) had less hospital readmissions and ER visits compared to telephone and control groups. The results of the study demonstrated a positive impact of post discharge telehealth monitoring for elderly cardiac surgery patients at high risk for readmission.
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See more of: Magnet Posters