Sang Wha Kim; Ju-Yeon Uhm; Yu Mi Im; Tae-Jin Yun; Jeong-Jun Park; Chun Soo Park

doi:10.4040/jkan.2014.44.2.228

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Original Article
Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease: Sang Wha Kim, Ju-Yeon Uhm, Yu Mi Im, Tae-Jin Yun, Jeong-Jun Park, Chun Soo Park; Journal of Korean Academy of Nursing 2014;44(2):228-236.
DOI: https://doi.org/10.4040/jkan.2014.44.2.228
Published online: April 30, 2014

¹Department of Nursing, Asan Medical Center, Seoul, Korea.

²College of Medicine, Ulsan University, Seoul, Korea.

Address reprint requests to: Uhm, Ju-Yeon. Department of Nursing, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-10-2571-2137, Fax: +82-2-3010-6108, jyuhm@amc.seoul.kr

• Received: January 21, 2014 • Revised: February 5, 2014 • Accepted: April 7, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
REFERENCES

Abstract

Purpose
Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality.
Methods
Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge.
Results
Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (χ²=1.15, p=.283).
Conclusion
Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.
Keywords: Telenursing; Congenital heart defects; Pediatric cardiac surgery; Home monitoring

REFERENCES

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Figure 1

Hotline triage protocol.

Figure 2

Primary outcome of death.

Table 1

Homogeneity Test for General Characteristics of Infants (N=84)

HMP=Home monitoring program; CPB=Cardiopulmonary bypass; ICU=Intensive care unit; VAI=Vasoactive inotropes.

Table 2

Reasons for Calling Telephone Health Care Services about Infant Health Problems and Frequency of Admission in Post HMP Group (N=41)

HMP=Home monitoring program; CNS=Clinical nurse specialist.

Figure & Data

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Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease

J Korean Acad Nurs. 2014;44(2):228-236. Published online April 30, 2014

DOI: https://doi.org/10.4040/jkan.2014.44.2.228

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Figure

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Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease

Figure 1 Hotline triage protocol.

Figure 2 Primary outcome of death.

Figure 1

Figure 2

Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease

Table 1

Homogeneity Test for General Characteristics of Infants (N=84)

HMP=Home monitoring program; CPB=Cardiopulmonary bypass; ICU=Intensive care unit; VAI=Vasoactive inotropes.

Table 2

Reasons for Calling Telephone Health Care Services about Infant Health Problems and Frequency of Admission in Post HMP Group (N=41)

HMP=Home monitoring program; CNS=Clinical nurse specialist.

Table 1 Homogeneity Test for General Characteristics of Infants (N=84)

HMP=Home monitoring program; CPB=Cardiopulmonary bypass; ICU=Intensive care unit; VAI=Vasoactive inotropes.

Table 2 Reasons for Calling Telephone Health Care Services about Infant Health Problems and Frequency of Admission in Post HMP Group (N=41)

HMP=Home monitoring program; CNS=Clinical nurse specialist.