Grace Williams, Karen Akroyd, Linda Burke

British Journal of Nursing, Vol. 19, Iss. 22, 09 Dec 2010, pp 1402 - 1407

Background: Chronic heart failure (CHF) prevalence is on the increase in the
UK, with readmissions to hospital and length of stay remaining a significant
problem both for patients and the NHS. The role of the clinical nurse specialist
in the management of CHF patients has yielded positive results in a number of
previous studies. Aim: To evaluate the effectiveness of a transitional care service
on readmissions and length of stay in hospital for patients with CHF. Design: A
quasi-experimental design was used over a period of 18 weeks. The historical
group (n=50) and the transitional care group (n=47) were compared. Method: The
study was carried out in an acute hospital trust. A patient questionnaire was used
as a post-intervention measure. Results: The number of readmissions was higher in
the control group (14%; n=7) compared with the transitional care group (8.5%;
n=4; P=0.526). Difference in length of stay for both groups almost achieved
statistical significance (P=0.06). Patients gave positive feedback about the service.
Conclusions: The results indicate that the introduction of the transitional care
service did not reduce the number of readmissions. The length of stay, if anything,
appeared to increase in the historical group when compared with the transitional
group. Although it was clear that the two groups were different in important ways,
causal effect cannot be attributed to the transitional care group as a result of
these other differences. Results from the patient satisfaction questionnaires used
in the transitional group did illustrate satisfaction with the discharge process and
care received.

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