Community Health Nursing Telemonitoring in Frail Elders With Congestive Heart Failure

2.50
Hdl Handle:
http://hdl.handle.net/10755/163553
Category:
Abstract
Type:
Presentation
Title:
Community Health Nursing Telemonitoring in Frail Elders With Congestive Heart Failure
Author(s):
Pastor, Diane
Author Details:
Diane Pastor, RN, BSN, MBA, Doctoral Nursing Student, Graduate Research Assistant, Columbia University School of Nursing, Northport, New York, USA, email: dkp2102@columbia.edu
Abstract:
Purpose: Heart failure is the most common reason for hospitalization among persons aged 65 or older and is also the primary diagnosis for a high share of home care admissions. A home telemonitoring program that may reduce heart failure rates of rehospitalization and number of nursing visits can save health care system resources and improve patient outcomes. Based on Donabedian's conceptual framework of quality, the purpose of this study was to evaluate patient and system outcomes of a community health home telemonitoring program for homebound frail elderly clients with congestive heart failure (CHF). Methods: Patients were eligible if they had either a primary or a secondary diagnosis of CHF. All CHF patients receiving telemonitoring during January 1 - May 31, 2004 in one suburban, independent, community health nursing organization were included. Data were collected through retrospective review chart review. Patient outcomes included length of stay on home care and emergent rehospitalization rates. System-level outcomes included the cost of services and utilization of home care services. Descriptive statistics and Chi-square were conducted. Results: A total sample of 160 elderly home care patients' records were reviewed (45 monitored patients and 115 unmonitored patients). There were no differences in patient demographics. The groups differed in length of stay on service (mean days 46.80, SD=28.04 for monitored patients versus mean days 34.87, SD=29.49 for unmonitored, p =.022), nursing visits (mean=12.82, SD=10.48 versus mean= 8.88, SD=8.76 for unmonitored, p=.017), and emergent rehospitalization rates (26.6% for monitored patients vs. 11.3% for unmonitored, p=.002). Mean costs of service were $2967.65 for monitored patients and $1993.47 for unmonitored patients. Conclusions and Implications: We found that patients receiving telemonitoring were more likely to be rehospitalized, had more nursing visits and longer lengths of stay in home care. These results were surprising and may be due to a number of factors. While every effort was made to ensure comparable groups, the patients receiving the telemonitoring intervention may have been at greater risk. However, the telemonitoring itself may help the nurses better assess the patients providing better access to needed care. A randomized clinical trial in the future would be beneficial. Consideration of proactive nursing intervention guidelines coupled with telemonitoring may improve patient and system outcomes in the future.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
17th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
New York, New York, USA
Description:
�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New York
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleCommunity Health Nursing Telemonitoring in Frail Elders With Congestive Heart Failureen_GB
dc.contributor.authorPastor, Dianeen_US
dc.author.detailsDiane Pastor, RN, BSN, MBA, Doctoral Nursing Student, Graduate Research Assistant, Columbia University School of Nursing, Northport, New York, USA, email: dkp2102@columbia.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163553-
dc.description.abstractPurpose: Heart failure is the most common reason for hospitalization among persons aged 65 or older and is also the primary diagnosis for a high share of home care admissions. A home telemonitoring program that may reduce heart failure rates of rehospitalization and number of nursing visits can save health care system resources and improve patient outcomes. Based on Donabedian's conceptual framework of quality, the purpose of this study was to evaluate patient and system outcomes of a community health home telemonitoring program for homebound frail elderly clients with congestive heart failure (CHF). Methods: Patients were eligible if they had either a primary or a secondary diagnosis of CHF. All CHF patients receiving telemonitoring during January 1 - May 31, 2004 in one suburban, independent, community health nursing organization were included. Data were collected through retrospective review chart review. Patient outcomes included length of stay on home care and emergent rehospitalization rates. System-level outcomes included the cost of services and utilization of home care services. Descriptive statistics and Chi-square were conducted. Results: A total sample of 160 elderly home care patients' records were reviewed (45 monitored patients and 115 unmonitored patients). There were no differences in patient demographics. The groups differed in length of stay on service (mean days 46.80, SD=28.04 for monitored patients versus mean days 34.87, SD=29.49 for unmonitored, p =.022), nursing visits (mean=12.82, SD=10.48 versus mean= 8.88, SD=8.76 for unmonitored, p=.017), and emergent rehospitalization rates (26.6% for monitored patients vs. 11.3% for unmonitored, p=.002). Mean costs of service were $2967.65 for monitored patients and $1993.47 for unmonitored patients. Conclusions and Implications: We found that patients receiving telemonitoring were more likely to be rehospitalized, had more nursing visits and longer lengths of stay in home care. These results were surprising and may be due to a number of factors. While every effort was made to ensure comparable groups, the patients receiving the telemonitoring intervention may have been at greater risk. However, the telemonitoring itself may help the nurses better assess the patients providing better access to needed care. A randomized clinical trial in the future would be beneficial. Consideration of proactive nursing intervention guidelines coupled with telemonitoring may improve patient and system outcomes in the future.en_GB
dc.date.available2011-10-27T11:09:33Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:09:33Z-
dc.conference.date2005en_US
dc.conference.name17th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationNew York, New York, USAen_US
dc.description�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New Yorken_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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