Advanced Practice Nurse Mc Gill University Health Center Montreal, Quebec, Canada
Disclosure(s):
Millie Kathleen Firmin, RN, BScN, MN: No financial relationships to disclose
Background: As surgical techniques and postoperative care improve, cardiac surgery patients are now on accelerated trajectories to be discharged as soon as possible. Although discharge information and booklets are provided to patients, given the stress and anxiety that normally surrounds the discharge process and the accelerated time to discharge, many are not able to adequately comprehend the information provided. Once discharged, patients have continuing needs for support as there can be complications that arise at home. There is a gap in support from when they are discharged to when they are seen by a cardiologist. At a quaternary healthcare centre in Canada, the cardiac surgery unit was observing many patients calling back the unit with various questions about their health, postoperative concerns, or complications. These calls were answered by the nurses on the unit resulting in an increase workload and time being taken away from their bedside care. Further, the information given to patients was not being given in a systematic way and the call was not documented in the patient’s chart.
METHODS AND RESULTS: A telenursing support program was initiated to offer postoperative follow-up. A nurse was assigned to receive all the calls that were previously made to the unit. Algorithms were developed for the nurse to triage receiving calls and respond to their needs or refer them to the appropriate services. These algorithms were developed in collaboration with the Nurse Practitioners, Advanced Practice Nurse, Nurse Manager and Surgical Chief of the department. All calls were documented in the patient’s electronic medical chart and were coded for the reason of call, and the nursing intervention that was performed with the patient on the phone.
Results: These follow-up telephone calls: 1) improve patient outcomes by addressing any medical concerns early, 2) provides an opportunity to reinforce teaching, 3) allows for patients to express any additional questions/concerns, and 4) provides a forum for discharged patients to have their needs met in addition to allowing the nurses on the unit more time for their inpatient responsibilities.
Conclusion: Telenursing support programs are an essential service that provide safe and quality care to patients. They provide information on how to better support cardiac surgery patients before and after being discharged home while providing redirection to outpatient services to mitigate unnecessary ED visits. This program can also serve as a guide for future telenursing programs.
