Ambulatory prostanoid therapy: safe reduction in duration of inpatient training.
Eur J Cardiovasc Nurs
; 20(6): 547-555, 2021 08 20.
Article
en En
| MEDLINE
| ID: mdl-34038534
ABSTRACT
AIMS:
IV prostanoid therapy for advanced pulmonary arterial hypertension requires lifelong, continuous infusion, and extensive self-care. The inpatient training pathway (ITP) ensures patient competency but can be psychologically and physically demanding. Therefore, an alternative Elective Prostanoid Admission Pathway (EPAP) was developed.Compare clinical outcomes and patient experiences for patients following the EPAP vs. the ITP. METHODS ANDRESULTS:
From 2013, clinically stable patients were trained via the EPAP, which consisted of pre-admission including an outpatient training day, followed by inpatient training. The EPAP patients were followed-up face-to-face/via telephone and could access a Clinical Nurse Specialist-led telephone service between appointments. Very high-risk patients were trained via the ITP, which consisted of pre-therapy counselling and daily ward-based training. Prior to 2013, patients followed the ITP pathway irrespective of clinical status. All were enrolled into the 'IV buddy' scheme and retrospectively asked to complete patient experience surveys. Among EPAP (n = 24) and ITP (n = 54) patients, 17% and 33% discontinued therapy, respectively. Among all, frequent challenges to treatment initiation were dexterity (43%) and body image (27%). Elective Prostanoid Admission Pathway use reduced inpatient stay duration by 8 days per patient and infection rates remained low. Patient experience surveys [n = 17 (EPAP), n = 10 (ITP)] showed equal patient satisfaction between groups, but the incidence of side effects was numerically lower in EPAP patients, who also reported home practice and having access to the 'IV buddy' scheme as 'very useful' [12/14 (86%) and 10/13 (77%), respectively].CONCLUSIONS:
Elective Prostanoid Admission Pathway implementation improved patient outcomes and has the potential for application to other clinical scenarios where patient self-management is required.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Prostaglandinas
/
Pacientes Internos
Tipo de estudio:
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Eur J Cardiovasc Nurs
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
ENFERMAGEM
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido