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Transitional Care of Adults with Chronic Diseases Post-Discharge from Acute Settings

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Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually,

Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

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Date Created
  • 2020-05-05

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Use of Virtual Reality Videos to Reduce Anxiety for Radiation Oncology Patients

Description

Purpose: To implement a non-pharmacologic approach to reduce anxiety in patients receiving radiation treatment.

Background and Significance: Anxiety is a prevalent health problem affecting up to 30% of the general population.

Purpose: To implement a non-pharmacologic approach to reduce anxiety in patients receiving radiation treatment.

Background and Significance: Anxiety is a prevalent health problem affecting up to 30% of the general population. Over 95% of radiation oncology patients report anxiety often related to not knowing what to expect during treatments. The current guideline for management of anxiety is the use of benzodiazepines; which can impose a risk to patients. Evidence demonstrates virtual reality videos can be an effective non-pharmacologic approach to reduce anxiety..

Design: Observational cohort evidence based project.

Setting: Outpatient radiation oncology facility in the Southwest United States.

Sample: 40 patients who have not previously undergone radiation therapy, but have been prescribed radiation treatments for malignant or non malignant conditions.

Methods: Patients who had not previously undergone radiation treatments were identified based on chart review and consented for participation in the project. The patient's were assessed for both their general (trait) anxiety and situational (state) anxiety using The State Trait Anxiety inventory (STAI). They were then shown a virtual reality video that walked them through what they would experience during their radiation treatment. The patient's were re-administered the STAI questionnaire following the video to assess any change in anxiety levels.

Variables: Trait and State anxiety scores before and after the virtual reality video intervention.

Findings/Outcomes: A paired t-test was conducted to assess the data. There was a significant difference in the state anxiety scores pre intervention (m = 32.65, SD = 11.47) and post intervention (M = 25.50, SD 8.95), p =< 0.001.

Conclusions: The use of virtual reality videos was an effective non-pharmacological approach to reduce anxiety in patients receiving radiation treatment.

Implications for nursing: The results provide support for the use of a virtual reality intervention as a non-pharmacologic option to reduce anxiety for patients.

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Date Created
  • 2017-05-02