A home health intervention for CHF patients reduced the variation in nursing visits provided (p<0.05) and marginally reduced visit volume (p=0.074), without improving other clinical outcomes.
RCT (n=371)
Randomized
No
This study examines the effects of a home health intervention designed to standardize nursing care, strengthen nurses' support for patient self-management and yield better CHF patient outcomes. Participants were 371 Medicare CHF patients served by 205 nurses randomized to intervention and control groups in a large urban home healthcare agency (HHA). The intervention consisted of an evidence-based nursing protocol, patient self-care guide, and training to improve nurses'teaching and support skills. Outcome measures included home care,physician and emergency department (ED) use, hospital admission, condition-specific quality of life (QoL), satisfaction with home care services and survival at 90 days. The intervention was associated with a marginally significant reduction in the volume of skilled nursing visits (p = .074), and a reduction variation in the typical number of visits provided (p < .05), without a significant increase in physician or ED use or patient mortality. Hypothesized improvement in other outcomes did not occur.
Feldman et al. (Mon,) conducted a rct in Congestive Heart Failure (n=371). Home health intervention (evidence-based nursing protocol, patient self-care guide, and training) vs. Control was evaluated on Home care, physician and emergency department use, hospital admission, condition-specific quality of life, satisfaction with home care services and survival at 90 days. A home health intervention for CHF patients reduced the variation in nursing visits provided (p<0.05) and marginally reduced visit volume (p=0.074), without improving other clinical outcomes.