Effect of integrating a multidisciplinary team in monitoring patients undergoing coronary artery bypass graft with the telehealth program on functional status readmission and satisfaction of the multidisciplinary team
Keywords:
telehealth monitoring, integrating multidisciplinary, patients with coronary artery bypass graft, multidisciplinary team satisfactionAbstract
The purpose of this controlled trial was to study the effects of integrating a multidisciplinary team of remote tracking CABG patients in a 4-week post-discharge from the hospital with a telehealth program based on Naylor’s transitional care model conceptual framework. Selecting patients who are prepared to be discharged from the hospital were randomized into two groups. 32 patients were assigned to the intervention group and received the telehealth program. The other 32 were assigned to the control group and received normal care. Data were collected using the three questionnaires, including a Demographic Data Questionnaire, a Functional Status questionnaire, a Re-admission Questionnaire, and a Multidisciplinary Team Satisfaction Questionnaire. Data were analyzed using independent t-test, Chi-square, and Mann-Whitney U Test to compare the mean scores of functional status and rehospitalization rate.
The results showed that the functional status in the experimental group was significantly higher than the control group in week 2 and week 4. Comparing the rate of readmission rate in the experimental group was significantly lower than the control group. The multidisciplinary satisfaction level was at an average high.
In conclusion, these results show the integration of multidisciplinary teams tracking CABG patients with the Telehealth programs benefits the recovery of patients and support the proactive work of the multidisciplinary team.
References
Bittner V. Functional status and outcome after coronary artery bypass grafting. J Am Coll Cardiol HF. 2014;2(4):344-6.
Yuan S-M, Lin H. Postoperative cognitive dysfunction after coronary artery bypass grafting. Braz J Cardiovasc Surg. 2019;34:76-84.
LaPier TK. Functional deficits at the time of hospital discharge in older patients following coronary artery bypass surgery-a pilot study. Cardiopulm Phys Ther J. 2014;25(4):98-105.
Barnason S, Zimmerman L, Nieveen J, Schulz P, Young L. Patient recovery and transitions after hospitalization for acute cardiac events: An integrative review. J Cardiovasc Nurs. 2012;27(2):175-91.
Mary A. Prevention of 30-Day Readmission after coronary artery bypass surgery. Wolters Kluwer Health. 2017;25(6):326-34.
Feng TR, White RS, Gaber-Baylis LK, Turnbull ZA, Rong LQ. Coronary artery bypass graft readmission rates and risk factors - a retrospective cohort study. Int J Surg. 2018;54(Pt A):7-17.
Fanari Z, Elliott D, Russo CA, Kolm P, Weintraub WS. Predicting readmission risk following coronary artery bypass surgery at the time of admission. Cardiovasc Revasc Med. 2017;18(2):95-9.
Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. J Am Geriatr Soc. 2004;52(5):675-84.
Moazzami K, Dolmatova E, Maher J, Gerula C, Sambol J, Klapholz M, et al. In-hospital outcomes and complications of coronary artery bypass grafting in the United States between 2008 and 2012. J Cardiothorac Vasc Anesth. 2017;31(1):19-25.
Kleinpell RM, Avitall B, Catrambone C, Moore l, Thompson NT. Randomized trial of a discharge planning and telehealth intervention for patients aged 65 and older after coronary artery bypass surgery. Int J Clin Cardiol. 2015;2:044:1-6.
Bikmoradi A, Masmouei B, Ghomeisi M, Roshanaei G. Impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft surgery: a quasi-experimental study in Iran. Int J Med Inform. 2016;86:43-8.
Bikmoradi A, Masmouei B, Ghomeisi M, Roshanaei G, Masiello I. Impact of telephone counseling on the quality of life of patients discharged after coronary artery bypass grafts. Patient Educ Couns. 2017;100(12): 2290-6.
Sanonoi N, Asdornwised U, Wongkongkam K, Tocharoenchok T. Effects of a telehealth program on the functional status and rehospitalization rates of patients after coronary artery bypass grafts. Chula Med J. 2021;65(2):179-86. (in Thai).
Luckraz H, Norell M, Buch M, James R, Cooper G. Structure and functioning of a multidisciplinary ‘Heart Team’for patients with coronary artery disease: rationale and recommendations from a joint BCS/BCIS/ SCTS working group. Eur J Cardiothorac Surg. 2015;48(4):524-9.
Riley JP, Masters J. Practical multidisciplinary approaches to heart failure management for improved patient outcome. Eur Heart J Suppl. 2016;18(suppl_G):.G43-G52.
Polit D, Beck C. Essentials of nursing research. Ethics. 2012;23:2.
Huang K, Liu W, He D, Huang B, Xiao D, Peng Y, et al. Telehealth interventions versus center-based cardiac rehabilitation of coronary artery disease: a systematic review and meta-analysis. Eur J Prev Cardiol. 2015;22(8):959-71.
Mohammadpour A, Sharghi NR, Khosravan S, Alami A, Akhond M. The effect of a supportive educational intervention developed based on the Orem's self-care theory on the self-care ability of patients with myocardial infarction: a randomised controlled trial. J Clin Nurs. 2015;24(11-12):1686-92.
The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 9th ed. Boston, Mass: Little, Brown; 1994:253-56.
Moinpour CM, McCorkle R, Saunders J. Measuring functional status. In Frank-Stromborg, M. (Ed.). Boston: Jones and Bartlett Publishers; 1992. pp. 23-46.
Plangen C, Asdornwised U, Wiratchpintu P. The experiences of chest pain in coronary artery disease patients. J Nurs Sci 2007;25(2):35-46. (in Thai).
Pingmuang P, Chinchai P, Dhippayom JP. Internal Consistency and Inter-rater Reliability of the Functional Test for Hemiplegic Upper Extremity in Persons with Hemiplegia –Thai Version. J Thai Rehabil Med 2016;26(2):39-46. (in Thai).
Varma PK, Kundan S, Ananthanarayanan C, Panicker VT, Pillai VV, Sarma PS, et al. Demographic profile, clinical characteristics and outcomes of patients undergoing coronary artery bypass grafting—retrospective analysis of 4,024 patients. Indian J Thorac Cardiovasc Surg. 2014;30(4):272-7.
Nicolini F, Fortuna D, Contini GA, Pacini D, Gabbieri D, Zussa C, et al. The impact of age on clinical outcomes of coronary artery bypass grafting: long-term results of a real-world registry. Biomed Res Int. 2017;2017:9829487. https://doi.org/10.1155/2017/9829487
Nakon O, Sindhu S. Symptoms and functional status in patients with coronary artery bypass grafting: gender differences. Nurs Sci J Thail. 2016;34(3):94-105. (in Thai).
Maniar HS, Bell JM, Moon MR, Meyers BF, Marsala J, Lawton JS, et al. Prospective evaluation of patients readmitted after cardiac surgery: Analysis of outcomes and identification of risk factors. J Thorac Cardiovasc Surg. 2014;147(3):1013-20.
Naveed A, Azam H, Murtaza HG, Ahmad RA, Baig MAR. Incidence and risk factors of Pulmonary Complications after Cardiopulmonary bypass. Pak J Med Sci. 2017;33(4):993-6.
Wattradul D. Cardiac Rehabilitation : Transition care from hospital to home. Thai J Cardio-Thorac Nurs. 2015;26(1):89-103. (in Thai).
Dıgın F, Fındık UY. The Effect of Nurse Telephone Consultation After Coronary Artery Bypass on the Autonomy Level of Elderly Patients: A Quasi-Experimental Study. Med J Bakirkoy. 2021;17(2).
Tse G, Chan C, Gong M, Meng L, Zhang J, Su X-L, et al. Telemonitoring and hemodynamic monitoring to reduce hospitalization rates in heart failure: a systematic review and meta-analysis of randomized controlled trials and real-world studies. J Geriatr Cardiol. 2018;15(4):298.
Alimadadi E, Abbasinia M, Mohammadbeigi A, Abbasi M. Risk factors of readmission after coronary artery bypass graft surgery: A case-control study. Nurs Pract Today. 2020;7(4):295-301.
Toles M, Colón-Emeric C, Naylor MD, Barroso J, Anderson RA. Transitional care in skilled nursing facilities: a multiple case study. BMC Health Serv Res. 2016;16(1):1-14.
Aghdam MRF, Vodovnik A, Hameed RA. Role of telemedicine in multidisciplinary team meetings. J Pathol Inform. 2019;10.
Chintapanyakun T, Wongsri P, Chaiyaroj S. Predictive factors in quality of recovery among patients after coronary artery bypass graft surgery. Thai J Cardio-Thorac Nurs 2021;32(2): 30-43. (in Thai).
Cook DJ, Manning DM, Holland DE, Prinsen SK, Rudzik SD, Roger VL, et al. Patient engagement and reported outcomes in surgical recovery: effectiveness of an e-health platform. J Am Coll Surg. 2013;217(4):648-55.
Akbari M, Celik S. The effects of discharge training and postdischarge counseling on quality of life after coronary artery bypass graft surgery. Nurs Midwifery Stud. 2018;7(3):105-10.
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