Implementation of an accelerated discharge process following percutaneous coronary intervention for patients with non-STelevation acute coronary syndromes.
Aims Historically, patients with non-ST elevation acute coronary syndrome (NSTE-ACS) are monitored as inpatients following successful percutaneous coronary intervention (PCI), but accumulating evidence demonstrates that accelerated discharge is safe, reduces cost, and enhances patient satisfaction....
| Publicado en: | European Journal of Cardiovascular Nursing Vol. 20; no. 7; pp. 660 - 667 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Oct2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154230916&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154230916 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14745151 KJC jtl: European Journal of Cardiovascular Nursing issn: 14745151 maglogo: N pubinfo: dt: Oct2021 vid: 20 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 154230916 154230916 154230916 10.1093/eurjcn/zvaa029 154230916 ppf: 660 ppct: 7 formats: tig: atl: Implementation of an accelerated discharge process following percutaneous coronary intervention for patients with non-STelevation acute coronary syndromes. aug: au: Slone, Sarah E. Barringhaus, Kurt G. Feldman, Barry Vismara, Vince Baker, Deborah affil: University of South Carolina College of Nursing, 1601 Greene St, Columbia, SC 29608, USA sug: subj: Acute Coronary Syndrome Therapy Percutaneous Coronary Intervention Patient Discharge Quality Improvement Implementation Science Length of Stay Adverse Health Care Event Prevention and Control Human Male Female Middle Age Aged Body Mass Index Nonexperimental Studies Data Analysis Software Descriptive Statistics Comparative Studies T-Tests Chi Square Test Fisher's Exact Test Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Aims Historically, patients with non-ST elevation acute coronary syndrome (NSTE-ACS) are monitored as inpatients following successful percutaneous coronary intervention (PCI), but accumulating evidence demonstrates that accelerated discharge is safe, reduces cost, and enhances patient satisfaction. This quality improvement project examined the impact of implementing a post-PCI streamlined discharge process for NSTE-ACS patients on length of stay (LOS), major adverse cardiovascular events, and provider utilization at a university-affiliated hospital system. Methods and results Clinical characteristics, the timing of admission, PCI, and discharge data were collected prospectively from patients presenting to the catheterization laboratory for intervention for NSTE-ACS during 90-day historical control and implementation periods. The knowledge to action implementation model was employed to establish a peer-coaching based educational tool for educating interventional cardiologists and inpatient clinicians regarding patients with low-risk characteristics suitable for same-day discharge (SDD) following PCI. Patient characteristics were similar between the historical and implementation periods. Although total hospital LOS did not decrease (51 ± 24 vs. 41 ± 18 h; P = 0.14), the discharge process reduced LOS after PCI among low-risk patients (22 ± 6 vs. 17 ± 8 h; P=0.003). Complication and readmission rates were unchanged by SDD. Provider utilization of the discharge process increased four-fold during the implementation period (8% vs. 32%; P = 0.02). Conclusions Implementation of an accelerated discharge process following PCI for low-risk NSTE-ACS patients reduced post-PCI LOS without increasing readmissions or complications. Increased utilization of the process throughout the implementation period may be attributed to peer coaching. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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