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Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD).
J Adv Nurs. 2005 Nov; 52(3):250-61.JA

Abstract

AIM

This paper reports a study evaluating the short-term impact of nursing-led, co-ordinated care after discharge following carotid endarterectomy.

BACKGROUND

Patient education about stroke risk factors, combined systematically with carotid endarterectomy, holds unrealized potential to improve patient outcomes. Nurses are well-placed in the healthcare system to co-ordinate this type of education.

METHODS

A randomized controlled trial was conducted between October 2001 and October 2002. Patients having carotid endarterectomy (n = 133) were randomized to either the intervention (n = 66) or control group (n = 67). The intervention consisted of telephone liaison with the patient by a Registered Nurse at 2, 6 and 12 weeks following carotid endarterectomy, combined with education about stroke risk factor management and structured liaison with the patient's surgeon and referring general practitioner. While patients allocated to the control group did not receive any postoperative telephone contact directly from the Registered Nurse during the study, their general practitioners received structured postoperative liaison.

RESULTS

The co-ordinated care postdischarge intervention had a statistically significant positive effect on patient knowledge of stroke warning signs (P = 0.002), patient self-reported changes to improve lifestyle (P = 0.006) and diet modification (P < 0.001). Statistically significant improvements from baseline to follow-up were detected in both groups for other outcomes.

CONCLUSIONS

While nursing-led, co-ordinated care after discharge achieves important improvements for short-term outcomes, carotid endarterectomy itself may have been a catalyst for improved patient outcomes. Further research of nursing-led co-ordinated care initiatives for vascular surgery patients is needed.

Authors+Show Affiliations

Middleton S
Australian Catholic University, North Sydney, New South Wales, Australia. s.middleton@mackillop.acu.edu.au
Donnelly N
No affiliation info available
Harris J
No affiliation info available
Ward J
No affiliation info available

MeSH

AgedAged, 80 and overCase ManagementEndarterectomy, CarotidExerciseFemaleHealth Knowledge, Attitudes, PracticeHealth StatusHumansLife StyleMaleMiddle AgedPatient Education as TopicPostoperative CarePostoperative ComplicationsRisk FactorsStrokeSurveys and Questionnaires

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16194178

Citation

Middleton, Sandy, et al. "Nursing Intervention After Carotid Endarterectomy: a Randomized Trial of Co-ordinated Care Post-Discharge (CCPD)." Journal of Advanced Nursing, vol. 52, no. 3, 2005, pp. 250-61.
Middleton S, Donnelly N, Harris J, et al. Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD). J Adv Nurs. 2005;52(3):250-61.
Middleton, S., Donnelly, N., Harris, J., & Ward, J. (2005). Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD). Journal of Advanced Nursing, 52(3), 250-61.
Middleton S, et al. Nursing Intervention After Carotid Endarterectomy: a Randomized Trial of Co-ordinated Care Post-Discharge (CCPD). J Adv Nurs. 2005;52(3):250-61. PubMed PMID: 16194178.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD). AU - Middleton,Sandy, AU - Donnelly,Neil, AU - Harris,John, AU - Ward,Jeanette, PY - 2005/10/1/pubmed PY - 2006/2/4/medline PY - 2005/10/1/entrez SP - 250 EP - 61 JF - Journal of advanced nursing JO - J Adv Nurs VL - 52 IS - 3 N2 - AIM: This paper reports a study evaluating the short-term impact of nursing-led, co-ordinated care after discharge following carotid endarterectomy. BACKGROUND: Patient education about stroke risk factors, combined systematically with carotid endarterectomy, holds unrealized potential to improve patient outcomes. Nurses are well-placed in the healthcare system to co-ordinate this type of education. METHODS: A randomized controlled trial was conducted between October 2001 and October 2002. Patients having carotid endarterectomy (n = 133) were randomized to either the intervention (n = 66) or control group (n = 67). The intervention consisted of telephone liaison with the patient by a Registered Nurse at 2, 6 and 12 weeks following carotid endarterectomy, combined with education about stroke risk factor management and structured liaison with the patient's surgeon and referring general practitioner. While patients allocated to the control group did not receive any postoperative telephone contact directly from the Registered Nurse during the study, their general practitioners received structured postoperative liaison. RESULTS: The co-ordinated care postdischarge intervention had a statistically significant positive effect on patient knowledge of stroke warning signs (P = 0.002), patient self-reported changes to improve lifestyle (P = 0.006) and diet modification (P < 0.001). Statistically significant improvements from baseline to follow-up were detected in both groups for other outcomes. CONCLUSIONS: While nursing-led, co-ordinated care after discharge achieves important improvements for short-term outcomes, carotid endarterectomy itself may have been a catalyst for improved patient outcomes. Further research of nursing-led co-ordinated care initiatives for vascular surgery patients is needed. SN - 0309-2402 UR - https://www.unboundmedicine.com/medline/citation/16194178/Nursing_intervention_after_carotid_endarterectomy:_a_randomized_trial_of_Co_ordinated_Care_Post_Discharge__CCPD__ DB - PRIME DP - Unbound Medicine ER -