Staveski Sandra L, Zhelva Bistra, Paul Reena, Conway Rosalind, Carlson Anna, Soma Gouthami, Kools Susan, Franck Linda S
University of California at San Francisco School of Nursing, San Francisco, CA, USA
Children's HeartLink, Edina, MN, USA.
World J Pediatr Congenit Heart Surg. 2015 Jan;6(1):18-25. doi: 10.1177/2150135114554659.
In developing countries, more children with complex cardiac defects now receive treatment for their condition. For successful long-term outcomes, children also need skilled care at home after discharge. The Parent Education Discharge Instruction (PEDI) program was developed to educate nurses on the importance of discharge teaching and to provide them with a structured process for conducting parent teaching for home care of children after cardiac surgery. The aim of this pilot study was to generate preliminary data on the feasibility and acceptability of the nurse-led structured discharge program on an Indian pediatric cardiac surgery unit.
A pre-/post-design was used. Questionnaires were used to evaluate role acceptability, nurse and parent knowledge of discharge content, and utility of training materials with 40 nurses and 20 parents. Retrospective audits of 50 patient medical records (25 pre and 25 post) were performed to evaluate discharge teaching documentation.
Nurses' discharge knowledge increased from a mean of 81% to 96% (P = .001) after participation in the training. Nurses and parents reported high levels of satisfaction with the education materials (3.75-4 on a 4.00-point scale). Evidence of discharge teaching documentation in patient medical records improved from 48% (12 of 25 medical records) to 96% (24 of 25 medical records) six months after the implementation of the PEDI program.
The structured nurse-led parent discharge teaching program demonstrated feasibility, acceptability, utility, and sustainability in the cardiac unit. Future studies are needed to examine nurse, parent, child, and organizational outcomes related to this expanded nursing role in resource-constrained environments.
在发展中国家，越来越多患有复杂心脏缺陷的儿童现在正在接受相关疾病的治疗。为了获得成功的长期治疗效果，儿童出院后在家中也需要专业护理。制定家长教育出院指导（PEDI）计划的目的是让护士了解出院指导的重要性，并为他们提供一个结构化的流程，以便对心脏手术后儿童的家庭护理进行家长教育。这项试点研究的目的是收集初步数据，以评估在印度儿科心脏手术科室由护士主导的结构化出院计划的可行性和可接受性。
采用前后设计。通过问卷调查评估40名护士和20名家长对角色的可接受性、护士和家长对出院内容的了解以及培训材料的实用性。对50份患者病历（25份术前和25份术后）进行回顾性审核，以评估出院指导文件记录情况。
参与培训后，护士的出院知识平均水平从81%提高到96%（P = .001）。护士和家长对教育材料的满意度较高（4分制中为3.75 - 4分）。PEDI计划实施六个月后，患者病历中的出院指导文件记录证据从48%（25份病历中的12份）提高到96%（25份病历中的24份）。
由护士主导的结构化家长出院指导计划在心脏科显示出可行性、可接受性、实用性和可持续性。未来需要开展研究，以考察在资源有限的环境中，与这一扩大的护理角色相关的护士、家长、儿童及组织方面的成果。
