Effectiveness of advanced practice nurse-led telehealth on readmissions and health-related outcomes among patients with post-acute myocardial infarction: ALTRA Study Protocol
Koh, Karen Wei Ling Wang, Wenru Richards, A Mark Chan, Mark Y Cheng, Karis Kin Fong
Cheng, Karis Kin Fong
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Abstract
Aim: To develop and examine the effectiveness of an advanced practice nurse-led telehealth rehabilitative programme as a transitional nursing therapeutic on readmission rates and health-related outcomes among patients with acute myocardial infarction postdischarge. Background: Patients suffering from acute myocardial infarction are experiencing an increasing trend of frequent readmissions. This implicates both the effectiveness of healthcare services and patient's quality of life. Advanced Practice Nurse-led telehealth rehabilitative programme has yet to be explored as a strategy to minimize preventable readmissions and improve patient's self-efficacy so as to enhance quality of life after a heart attack. Design: Randomized controlled trial with repeated measures. Methodology: A consecutive sampling of 172 patients with acute myocardial infarction will be recruited from a tertiary acute hospital in Singapore. Participants will be randomized into two groups. The experimental group (ALTRA) will receive Advanced Practice Nurse-led telehealth rehabilitative programme on discharge. The control group will receive only standard follow-up care. The outcome measures include readmissions, cardiac self-efficacy, cardiovascular risk factors, quality of life, anxiety and depression. The data will be collected at the baseline, 1 and 6 month postdischarge. A postprogramme evaluation will be conducted among the participants to assess its acceptability, strengths and weakness. Discussion: ALTRA aims to engage and support patients with acute myocardial infarction by increasing self-care management through education and telehealth contacts with Advanced Practices Nurses. This provides a smoother transition of illness to health and ultimately, reduces preventable costly readmissions. Trial registration: The study has been registered with clinicaltrials.gov. The trial registration number is NCT02483494.
Keywords
Science & Technology, Life Sciences & Biomedicine, Nursing, advanced practice nurse, cardiac rehabilitation, health-related outcomes, postacute myocardial infarction, readmissions, telehealth, CORONARY-HEART-DISEASE, RANDOMIZED CONTROLLED-TRIAL, ASSESSMENT SCALE MIDAS, QUALITY-OF-LIFE, ARTERY-DISEASE, SELF-EFFICACY, FAILURE, CARE, MANAGEMENT, TRANSITIONS
Source Title
JOURNAL OF ADVANCED NURSING
Publisher
WILEY
Series/Report No.
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Date
2016-06-01
DOI
10.1111/jan.12933
Type
Article