Key result
NP-led telephone practice linked to ~81% fewer ED visits for AF.
Why the study?
AF care can be episodic and heavily reliant on emergency department resources, putting presenting patients at high risk of hospital admission.
Does a nurse practitioner-led telephone practice reduce emergency department visits in patients with atrial fibrillation?
Observational (n=90)
No
Does a nurse practitioner-led telephone practice reduce emergency department visits in patients with atrial fibrillation?
A nurse practitioner-led telephone follow-up program significantly reduced emergency department visits for patients with atrial fibrillation.
Answers are grounded in this paper and cite their sources.
May support fewer ED visits in AF via NP telehealth; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Between 2010 and 2012, the Heart Rhythm team in a tertiary care hospital completed a retrospective study that found that atrial fibrillation (AF) care can be episodic and heavily reliant on hospital resources, particularly the emergency department (ED). PROBLEM: Patients who attend the ED with AF are at high risk of hospital admission. APPROACH: A nurse practitioner (NP) was added to the Heart Rhythm team to create a program to improve AF care after an ED visit. Telephone practice was one of the many processes created. OUTCOMES: Findings revealed that 37 of 90 patients presented to the ED with AF prior to telephone contact and 7 of 90 patients did so post-telephone contact (P < .001). CONCLUSION: Telephone practice led by an NP provides an opportunity to improve assessment and management of patient with AF and offers a promising cost-effective method to reduce ED visits in the AF patient population.
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Hart et al. (2018) conducted an observational in Atrial fibrillation (n=90). Nurse practitioner-led telephone practice vs. Prior to telephone contact was evaluated on Emergency department presentation with atrial fibrillation (p=< .001). Nurse practitioner-led telephone practice reduced emergency department visits for atrial fibrillation from 41.1% prior to contact to 7.8% post-contact (P < .001).
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