Article type
Abstract
Background: Heart failure (HF) is a major public health concern which contributes significantly to rising healthcare costs. A comprehensive discharge planning can improve health outcomes and reduce readmission rates which, in turn, could lead to cost savings
Objectives: The aim of this project was to promote best practice in the discharge planning of HF patients admitted in the coronary care unit (CCU) of Zhongshan Hospital.
Methods: A clinical audit was undertaken using the Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System (PACES) tool. Five audit criteria that represent best-practice recommendations for HF discharge planning were used. A baseline audit was conducted followed by the implementation of multiple strategies and finalised with a follow-up audit to determine change in practice.
Results: Improvements in practice were observed for all five criteria. The most significant improvements were found for the following: completion of a discharge checklist (0%→100% compliance), comprehensive (i.e. inclusion of six topics for self-care) discharge education for patients (7%→100% compliance), and conducting a telephone follow-up (0%→76%). The compliance rates for the two remaining criteria, completion of a structured education for patients and scheduling an outpatient clinic visit, both increased from 93% to 100%. Strategies that were implemented to achieve change in practice included development of a local discharge planning checklist, provision of training for nurses, and development of resources.
Conclusions: The project demonstrated positive changes in the discharge planning practices of nurses in the CCU. A formalised discharge planning is currently in place and plans for sustaining practice change are under way. A continuous cycle of audit and re-audit will need to be carried in the future to determine the impact of this evidence implementation activity on HF patient outcomes.
Objectives: The aim of this project was to promote best practice in the discharge planning of HF patients admitted in the coronary care unit (CCU) of Zhongshan Hospital.
Methods: A clinical audit was undertaken using the Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System (PACES) tool. Five audit criteria that represent best-practice recommendations for HF discharge planning were used. A baseline audit was conducted followed by the implementation of multiple strategies and finalised with a follow-up audit to determine change in practice.
Results: Improvements in practice were observed for all five criteria. The most significant improvements were found for the following: completion of a discharge checklist (0%→100% compliance), comprehensive (i.e. inclusion of six topics for self-care) discharge education for patients (7%→100% compliance), and conducting a telephone follow-up (0%→76%). The compliance rates for the two remaining criteria, completion of a structured education for patients and scheduling an outpatient clinic visit, both increased from 93% to 100%. Strategies that were implemented to achieve change in practice included development of a local discharge planning checklist, provision of training for nurses, and development of resources.
Conclusions: The project demonstrated positive changes in the discharge planning practices of nurses in the CCU. A formalised discharge planning is currently in place and plans for sustaining practice change are under way. A continuous cycle of audit and re-audit will need to be carried in the future to determine the impact of this evidence implementation activity on HF patient outcomes.