Planlı hastane taburculuk programının koroner arter baypas greftleme yapılan hastalarda komplikasyonlar ve hastane geri dönüşleri üzerine etkisi

Amaç: Bu çalışmada, koroner arter baypas greftleme yapılan hastalarda planlı hastane taburculuk programının (taburculuk eğitimi, telefon danışmanlığı ve ev ziyareti) komplikasyonlar ve hastaneye geri dönüş üzerine etkisi araştırıldı. Çalışma planı: Bu randomize kontrollü, tek kör çalışmada randomizasyon yaş, cinsiyet ve eğitim durumu olmak üzere, üç değişkene göre yapıldı. Çalışmaya toplam 60 hasta alındı ve her grupta 30’ar hasta olacak şekilde kontrol ve girişim olmak üzere rastgele gruplara ayrıldı. Taburculuk programı girişim grubuna uygulandı. Hastalar ev ziyaretinde değerlendirildi. Bulgular: Deney grubu hastaların tamamına yakınında sistolik ve diyastolik kan basıncı, nabız, vücut ısısı, bağırsak sesleri, ödem, triflow kullanımı ve akciğer sesleri gibi fizik muayene bulguları normaldi ve istirahat ve dil altı hapa rağmen geçmeyen ağrı, nefes darlığı ile birlikte olan çarpıntı, istirahat ile geçmeyen nefes darlığı, günde 1-1.5 kg’dan fazla kilo artışı, 38.0 °C dereceyi geçen vücut ısısı ve insizyon bölgesinde iltihaplı akıntı, kızarma, şişme gibi komplikasyonlar gözlenmedi. Girişim grubunda 59 hastanın 54’ünde hastaneye plansız geri dönüş engellendi ve beş hastanın hastaneye geri dönüşü istendi. Kontrol grubundaki 22 hasta bir kez, beş hasta ise iki kez hastaneye plansız geri dönüş yaptı. Sonuç: Çalışma sonuçlarımız, koroner arter baypas greftleme yapılan hastalara uygulanan planlı taburculuk programının ameliyat sonrası bakımının sağlanmasında ve komplikasyonların ile hastaneye plansız geri dönüşlerin önlenmesinde etkili olduğunu göstermektedir.

The impact of planned hospital discharge program on complications and hospital readmissions in patients undergoing coronary artery bypass grafting

Background: This study aims to investigate the impact of planned hospital discharge program (discharge training, phone consulting, and home visiting) on complications of patients undergoing coronary artery bypass grafting and on their return to hospital.Methods: In this randomized-controlled, single-blind study,randomization was done based on three variables: age, gender, and education status. In total, 60 patients were included and were randomly divided into control and intervention groups as 30 patients in each group. Discharge program was applied to the intervention group. The patients were evaluated with home visits.Results: Almost all of the intervention group patients had normal physical examination findings such as systolic and diastolic blood pressure, pulse, body temperature, bowel sounds, edema, use of triflow and lung sounds, and they experienced no complications such as persistent pain, despite resting and sublingual pills, palpitation with shortness of breath, persistent shortness of breath despite resting, increased body weight of more than 1 to 1.5 kg per day, body temperature more than 38.0 °C and inflammatory flow, flushing and swell in incision area. Unintended return back to the hospital in the intervention group was prevented in 54 of 59 patients and was requested for five patients. In the control group, 22 patients returned back to the hospital for the first time and five for the second time.Conclusion: Our study results demonstrate that planned discharge program applied on patients with coronary artery bypass grafting is effective in the management of postoperative care and preventing complications and unintended returns back to the hospital.

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