Hostname: page-component-745bb68f8f-s22k5 Total loading time: 0 Render date: 2025-01-12T21:22:45.895Z Has data issue: false hasContentIssue false
  • English
  • Français

Parent education discharge instruction program for care of children at home after cardiac surgery in Southern India

Published online by Cambridge University Press:  17 November 2015

Sandra L. Staveski ,
V. P. Parveen ,
Sai B. Madathil ,
Susan Kools  and
Linda S. Franck
Sandra L. Staveski*
Affiliation:
Cincinnati Children’s Hospital Medical Center, Research in Patient Services, Heart Institute, Cincinnati, Ohio, United States of America
V. P. Parveen
Affiliation:
Amrita Institute of Medical Sciences, Amrita Lane, Kochi, Kerala, India
Sai B. Madathil
Affiliation:
Amrita Institute of Medical Sciences, Amrita Lane, Kochi, Kerala, India
Susan Kools
Affiliation:
University of Virginia School of Nursing, Charlottesville, Virginia, United States of America
Linda S. Franck
Affiliation:
University of California San Francisco School of Nursing, San Francisco, California, United States of America
*
Correspondence to: S. L. Staveski, Research in Patient Services, Heart Institute, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, United States of America. Tel: 513-803-7636; Fax: 513-636-9765; E-mail: Sandra.staveski@cchmc.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

In many developing countries, children with CHD are now receiving surgical repair or palliation for their complex medical condition. Consequently, parents require more in-depth discharge education programmes to enable them to recognise complications and manage their children’s care after hospital discharge. This investigation evaluated the effectiveness of a structured nurse-led parent discharge teaching programme on nurse, parent, and child outcomes in India.

Materials and methods

A quasi-experimental investigation compared nurse and parent home care knowledge before and at two time points after the parent education discharge instruction program’s implementation. Child surgical-site infections and hospital costs were compared for 6 months before and after the discharge programme’s implementation.

Results

Both nurses (n=63) and parents (n=68) participated in this study. Records of 195 children who had undergone cardiac surgery were reviewed. Nurses had a high-level baseline home care knowledge that increased immediately after the discharge programme’s implementation (T1=24.4±2.89; T2=27.4±1.55; p<0.005; 30 point scale), but decreased to near baseline (T3=23.8±3.4; ns) 4 months after the programme’s implementation. Nurse teaching documentation increased by 56% after the programme’s implementation. Parent knowledge scores increased from 1.76±1.4 for Cohort 1 to 3.68±0.852 for Cohort 2 (p<0.005; 0–4 scale) after the discharge programme’s implementation. Surgical-site infections decreased from 27% in Cohort 1 to 2% in Cohort 2 (p>0.05) after the programme’s implementation.

Conclusion

Nurse, parent, and child outcomes were improved after implementation of the structured nurse-led parent discharge programme for parents in India. Structured nurse-led parent discharge programmes may help prepare parents to provide better home care for their children after cardiac surgery. Further investigation of causality and influencing factors is warranted.

Keywords

Parent educationcardiac surgerydischarge
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1213 - 1220
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Lincoln, P, Cusick, M, Fantegrossi, J, et al. Congenital cardiac patients—fetus to adult: nursing considerations. In Da Cruz EM, Ivy D, Jaggers J (eds). Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care, Volume 3. Springer Reference, New York, 2014: 1309–1329.Google Scholar
2. Clare, MD. Home care of infants and children with cardiac disease. Heart Lung 1985; 14: 218–222.Google Scholar
3. Cua, YM, Kripalani, S. Medication use in the transition from hospital to home. Ann Acad Med Singapore 2008; 37: 136–141.Google Scholar
4. Katz, MG, Jacobson, TA, Veledar, E, et al. Patient literacy and question-asking behavior during the medical encounter: a mixed-methods analysis. J Gen Intern Med 2007; 22: 782–786.Google Scholar
5. Lerret, S. Discharge readiness: an integrative review focusing on discharge following pediatric hospitalization. J Pediatr Nurs 2009; 14: 245–255.Google Scholar
6. Staveski, SL, Zheleva, B, Paul, R, et al. Pediatric cardiac surgery parent education discharge instruction (PEDI) program: a pilot study. World J Pediatr Congenit Heart Surg 2015; 6: 18–25.CrossRefGoogle ScholarPubMed
7. Jenkins, KJ, Gauvreau, K, Newburger, JW, Spray, TL, Moller, JH, Iezzoni, LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002; 123: 10–18.Google Scholar
8. Wang, N, Hailey, D, Yu, P. Quality of nursing documentation and approaches to its evaluation: a mixed methods systematic review. J Adv Nurs 2011; 67: 1858–1875.CrossRefGoogle Scholar
9. Tandulwadikar, A, Chigullaplli, R. World Class via Accreditaion. Retrieved October 18, 2012, from http://www.asianhhm.com.Knowledgebank/articles/healthcare-_accreditations_india Google Scholar
10. Tortoriello, TA, Friedman, JD, McKenzie, ED, et al. Mediastinitis after pediatric cardiac surgery: a 15-year experience at a single institution. Ann Thorac Surg 2003; 761: 655–660.Google Scholar
11. Woodward, CS, Son, M, Taylor, R, Husain, SA. Prevention of sternal wound infection in pediatric cardiac surgery: a protocolized approach. World J Pediatr Congenit Heart Surg 2012; 3: 463–469.CrossRefGoogle ScholarPubMed
12. Rao, SG. Pediatric cardiac surgery in developing countries. Pediatr Cardiol 2007; 28: 144–148.Google Scholar
13. Saxena, SG. Congenital heart disease in India: a status report. Indian J Pediatr 2005; 72: 595–598.Google Scholar
14. Blagojevic, J, Stephens, S. Evaluation of standardized teaching plans for hospitalized pediatric patients: a performance improvement project. J Healthc Qual 2008; 30: 16–27.Google Scholar