Development of a discharge planning practice guideline to reduce readmission in patients with acute myocardial ischemia. Nakhon Pathom Hospital

Abstract

Abstract                                                         

                The objectives of this research and development were to (1) develop a discharge planning practice guideline to reduce re-admission in patients with acute myocardial ischemia, (2) evaluate outcomes of the guideline implementation. The study consisted of 4 phases: 1) study problems and situations 2) develop the discharge planning practice guideline 3) implementation of the guideline 4) evaluate the guideline implementation. The sample comprised of 20 acute ischemic myocardial infarction patients and 30 nurses. The research instrument consisted of (1) the  discharge planning practice guideline (2) discharge planning assessment form (3) self-care teaching plan of the patients (4) self-care manual for acute ischemic myocardial infarction patients (5) follow-up record form for acute ischemic myocardial infarction patients after discharge by telephone (6) the patients satisfaction questionnaire (7) patients re-admission form (8) the nurses' opinions questionnaire on the possibility of guideline implementation (9) quality of the guideline questionnaire (10) the nurses satisfaction questionnaire. The content validity was 0.9 and Cronbach alpha was 0.95. Data were analyzed using mean, percentage, standard deviation, and t-test.

                The results revealed that the patients did not re-admit after discharge within 28 days after the practice guideline implementation. The average quality of the D-METHOD discharge planning guidelines was at a very good level and significantly higher than the previous version (p < 0.05). The feasibility of the guideline implementation was 100%. The guideline satisfaction of the patients and the nurses was at the highest level (Mean 4.88, SD 0.13 and Mean 4.46, SD 0.55) respectively.