| Learning Objective #1: Describe an innovative system of electronic monitoring for adults with chronic heart failure living at home | |||
| Learning Objective #2: Compare and contrast outcomes of traditional home care with electronic monitoring for adults with chronic heart failure living at home |
Objective: Homehealth service at the Visiting Nurse Association of Cleveland (VNAC) provides up-to-date care based on best practices. Research on electronic home-monitoring system (HMS) challenged us to update traditional home care practices. This study examined clinical outcomes of homecare for adults with CHF monitored electronically (CareWatch). Design/ Methods: Outcomes (e.g.V/S,Wt,Symptoms) were examined for 30 days after connecting CareWatch using OASIS records, VNAC Tele-Monitoring Data, and Patient Satisfaction Surveys. Sample/Setting: 16male/14 female adults with CHF; 9 non-white. Mean age of 80.0+7.2 years; 28 Medicare; 23 resided in their own homes; 9 lived alone; 19 had family as primary caregivers. Cognitive functioning – 17 completely intact; 13 “required some direction”. NY Heart Classification C with 4.9+2.1 additional diagnoses. Findings: No deaths, 2 rehospitalized, 1 MD visit (medication change),1 ER visit. Average 6+1.5 planned nursing visits, 20 % unscheduled nursing visit due to a monitor reading, 4+2.4 unscheduled phone calls. For 9 previous homecare patients total service days were cut from 449 before CareWatch to 164 after; emergency visits from 6 to 2. Older age R/T increased number of scheduled nursing visits (r=.676, p < >0001) but significantly less unscheduled visits (r=-365, p=.047). HMS was easy to use and practical. Patients reported good/excellent education on HMS, felt more involved in their care, had a sense of security and peace, and would use it again. Conclusions: Although past studies of people with CHF found that a critical time for readmission was the first weeks after hospital discharge, with a 15 to 20 % rate of rehospitalization, in this group of 30 clients using the CareWatch HMS, only 2 individuals were rehospitalized, one with a new problem. Patients had high satisfaction. Implications: Further study using a comparison group of non CareWatch patients to identify significant differences in outcomes using the HMS versus traditional care.
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