EVALUATION OF A PRE-ADMISSION CARDIAC SURGICAL CLINIC. P. Way*, G. Fairbrother, S. Grguric, J.
Broe. Cardiac Services Program, Prince of Wales
Hospital, Sydney, NSW. Aim: To compare short term patient outcome and cost of preparing
patients for cardiac surgery via group based (pre-admission clinic)
model vs individual (inpatient) model. Background: The provision of patient education prior to cardiovascular
surgery has been recognised as efficacious for some decades. There is increasing interest in the method
and timing of patient education.
Principal reasons for this are (i) acceptance of the link between
patient preparation and physical and psychological outcome1, (ii)
the decreasing time available for preoperative education due to shorter lengths
of hospital stay. The published
literature comprises descriptions and evaluation of a range of preparatory
interventions. Most effectiveness
studies have assessed individual information/education and/or individual
counselling vs control2. A
literature search failed to locate any experimental studies comparing group
(i.e. clinic based) vs individual preparation for cardiac surgery. Moving from an individual to clinic based patient preparation model
is likely to prove attractive to Australian health care administrators
as the clinic model allows for a shorter preoperative hospital length
of stay. The question remains however ‑- does the clinic
model yield similar, worse or better outcomes? Method & Results: In this prospective cohort study, patients
were allocated to clinic or inpatient preparation on the basis of proximity to
the hospital campus. Differences in
patient characteristic indicators (demographics and disease severity) between
the two groups were few. Outcome
comparison utilising multiple regression procedures indicated that physical
recovery, anxiety and patient satisfaction indicators did not differ between
those receiving preparation via the clinic (n=56) and those receiving routine
preparation (n=54). Cost comparison
confirmed that the clinic model yields benefits in patient stay terms. Feedback surveying indicated that those
receiving clinic preparation perceived greater relative/carer involvement in
their hospital admission. References: 1. Katz J (1997) Providing effective
patient teaching, American Journal of Nursing 97(5): 33-36 2. Moore S (1997) Effects of interventions
to promote recovery in coronary artery bypass surgical patients,
J Cardiovascular Nursing 12(1): 59-70
