Paper
Wednesday, July 21, 2004
This presentation is part of : Models for Improved Care
A Structured Approach to Improving Nursing Care and Decreasing Rehospitalizations of Home Care Patients with CHF
Christina Marie Quinn, RN, DNS, School of Nursing, School of Nursing, Georgia State University, Atlanta, GA, USA
Learning Objective #1: Describe an approach to CHF home care incorporating telephonic visits and using a standardized format for teaching
Learning Objective #2: Discuss the use of a patient notebook/log in improving self-care of CHF home care patients
Objective: The purpose of this study was to pilot test a structured intervention for home health care patients with congestive heart failure (CHF). Patients in the intervention group received a combination of teaching and skill building components along with home visits and telephone follow-up during the 9-week intervention. Data was collected before and after the intervention on symptom management, quality of life, and re-hospitalization. The study was designed to answer the question: What differences exist between CHF patients who receive the intervention and those who receive the current method of care on: re-hospitalization, quality of life, cardiac symptom status, medication compliance; and, vital signs including weight gain.

Design: This program evaluation has been designed as a comparative analysis between two groups of CHF home care patients. The control group was evaluated using the current approach to CHF patient care. The intervention group received a standardized approach designed by the investigator, which included home care and telephonic visits. Several instruments measured changes in patient status.

Sample, Setting: The setting was a rural home care agency with a high volume of CHF patients. Nurses in the agency were taught how to use the teaching tool, make telephonic visits, and administer the instruments. Patients were taught how to keep a notebook/log for vital signs and medication adherence. They also received scales and blood pressure cuffs for use during the study.

Findings: Data has been collected on all control patients. Several patients are enrolled in the intervention group and data analysis is ongoing. Projected date of completion of all data collection is May 2004.

Implications: Studies focused on nursing interventions will promote evidenced based practice in patients with chronic illness. Home care agencies will be interested in the findings of this research to improve nursing care and discover methods of decreasing hospital readmissions.

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Sigma Theta Tau International
July 21, 2004