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Parent education discharge instruction program for care of children at home after cardiac surgery in Southern India

Published online by Cambridge University Press:  17 November 2015

Sandra L. Staveski*
Affiliation:
Cincinnati Children’s Hospital Medical Center, Research in Patient Services, Heart Institute, Cincinnati, Ohio, United States of America
V. P. Parveen
Affiliation:
Amrita Institute of Medical Sciences, Amrita Lane, Kochi, Kerala, India
Sai B. Madathil
Affiliation:
Amrita Institute of Medical Sciences, Amrita Lane, Kochi, Kerala, India
Susan Kools
Affiliation:
University of Virginia School of Nursing, Charlottesville, Virginia, United States of America
Linda S. Franck
Affiliation:
University of California San Francisco School of Nursing, San Francisco, California, United States of America
*
Correspondence to: S. L. Staveski, Research in Patient Services, Heart Institute, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, United States of America. Tel: 513-803-7636; Fax: 513-636-9765; E-mail: Sandra.staveski@cchmc.org

Abstract

Introduction

In many developing countries, children with CHD are now receiving surgical repair or palliation for their complex medical condition. Consequently, parents require more in-depth discharge education programmes to enable them to recognise complications and manage their children’s care after hospital discharge. This investigation evaluated the effectiveness of a structured nurse-led parent discharge teaching programme on nurse, parent, and child outcomes in India.

Materials and methods

A quasi-experimental investigation compared nurse and parent home care knowledge before and at two time points after the parent education discharge instruction program’s implementation. Child surgical-site infections and hospital costs were compared for 6 months before and after the discharge programme’s implementation.

Results

Both nurses (n=63) and parents (n=68) participated in this study. Records of 195 children who had undergone cardiac surgery were reviewed. Nurses had a high-level baseline home care knowledge that increased immediately after the discharge programme’s implementation (T1=24.4±2.89; T2=27.4±1.55; p<0.005; 30 point scale), but decreased to near baseline (T3=23.8±3.4; ns) 4 months after the programme’s implementation. Nurse teaching documentation increased by 56% after the programme’s implementation. Parent knowledge scores increased from 1.76±1.4 for Cohort 1 to 3.68±0.852 for Cohort 2 (p<0.005; 0–4 scale) after the discharge programme’s implementation. Surgical-site infections decreased from 27% in Cohort 1 to 2% in Cohort 2 (p>0.05) after the programme’s implementation.

Conclusion

Nurse, parent, and child outcomes were improved after implementation of the structured nurse-led parent discharge programme for parents in India. Structured nurse-led parent discharge programmes may help prepare parents to provide better home care for their children after cardiac surgery. Further investigation of causality and influencing factors is warranted.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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