The heart disease patients often feel overwhelmed and do not understand about their disease after discharge from hospital that fail to manage their symptoms and became to readmitted hospital easily. According to CDC, approximately 610,000 people die every year because of heart disease and more than 50% of death from heart disease (CDC, 2017). So, nurses need to educate patients with heart disease well prior to discharge and follow up after discharge regarding medications, symptoms, managing diet and lifestyle. The purpose of this writing is to find out regarding patients with heart disease discharge to home with follow-up calls compared not follow up calls will improve managing their disease more effectively.
There are plenty articles regarding follow up care with CHF patients; however, the article, Sherrard et al. (2015) was using automated calling service for patient discharged with diagnosis of acute coronary syndrome to follow up care that reduce time and RN cost. Other interesting fact about the article, Sherrard et al. (2015), total of 4,722 patients were screened and 1,608 patients are randomized.
I was surprised with number of patients with acute coronary syndrome. Compared with other heart diseases, the number is cannot be ignored and need to follow up care immediately to reduce mortality and morbidity. Also, Sherrard el al. (2015) reports 30% of patients required a call for reassessment by RN after automated calling service and 93.4% of patients did not know their cholesterol levels after one year of hospital discharge. According to Sherrard et al, patients that received automated calling service showed 60% of significant improvement in medication compliance and reduced in medical visits (Sherrard et al.
According to Grove, reliability is related with the consistency in measurement methods (Groves, Gray & Burns, 2015, p.287). The article, Sherrard el al. (2015), they used 1,608 patients randomized and made automated calling every three months for one year; however, 261 patients out of 1,608 was not complete the one year follow up or did not answer any automated calls (Sherrard el al., 2015). According to Grove, test-retest reliability is repeating measures to test consistency or stability (Groves, el al.,2015, p.289). The article, Sherrard el al. (2015) used test-retest reliability since it repeated automated call service every three months until one year with big sample size, so the article was reliable.
According to Grove, evidence of validity from contrasting groups is two groups expect to have opposed scores (Grove et al., 2015, p. 289) In critiquing validity of article, Sherrard et al. (2015), they used randomized controlled trial which is strong method for testing effectiveness of treatment and evidence of validity from contrasting groups, one group is received automated calls and the other group received usual care after discharged to home (Sherrard et al., 2015).
Weakness point of this article, Sherrad et al., (2015) is that survey is based on automated calling that capture patient’s responding to question and flagged it if there is any needed by nurse to follow up. Since automated calling system asking simple questions required accepting yes or no answers, it will hard to assess real patient. Strong point of this article, Sherrad et al., (2015) is that authors used big sample size with randomized controlled trial that shows effectiveness of autonomic calling system that can be used in future study to improve patient’s heart disease management and reduce rehospitalization.
Education to patient with heart disease is really important. Discharge instruction is important but follow up is also important to improve patients’ selfcare skills. According to the article from International Journal Community-Based Nursing & Midwifery, during hospitalization, patients with Myocardia Infarction do not receive proper training for medication regimen and healthy diet because of short period of time staying at hospital (Najafi SS, Shaabani M, Mommennassab M & Aghasadeghi K, 2016). Also, 80% among 100 patients with MI in Shiraz was having unhealthy diet prior telephone follow up; however, after nurse giving telephone follow up for 12 weeks after discharge, 60% of them reported having heart healthy diet (Najafi et al., 2016). In addition, after nurse giving telephone follow up, 68% of patient reported high level of medication compliance (Najafi et al., 2016).
According one of article from British Journal of Cardiac Nursing, telephone follow up with heart disease, nine of 14 studies (n=2227) reported positive effect of emotional components of health related quality of life, anxiety and depression within six months after discharge (Phillips, P., 2014). Also, improved smoking secession noted with patient who received telephone follow up (Phillips, P., 2014). In addition, one of 14 studies but largest of studies found significant decreases in number of patient reporting dyspnea and chest pain after telephone follow up (Phillips, P., 2014).
According to article, Anderson, K (2014), clinical characteristics and symptoms at the end of hospitalization such as dyspnea, crackles, and ADLs are correlated hospital readmission within 60 days of discharge with heart failure patients. In research study, follow-up within 7 days was associated lower readmission rate with heart failure patients (Jackson, Shabsabebi, Wedlake &Dubard, 2015). Patient education to heart failure patients prior to discharge and follow up after discharge is really important to encourage patient to increase compliance with healthy diet, medication and monitoring symptoms. There is limited source of clinical practice with this topic but there is significant data that proves patients with heart disease discharged to home with follow-up calls compared not follow up calls improve managing their disease more effectively.