Pico questions related to emergency nursing

Citation:

Wong, F. K., Chow, S., Chang, K., Lee, A., & Liu, J. (2004). Effects of nurse follow-up on emergency room revisits: a randomized controlled trial. Social Science & Medicine, 59(11), 2207-2218. doi:10.1016/j.socscimed.2004.03.028

Study objective/ intervention or exposures compared

Design

Sample (N)

Intervention

Outcomes studied (how measured)

Results

Level

To assess the impact of follow-up phone calls by a nurse on ER patients post discharge at an urban acute care hospital on health outcomes and utilization of healthcare providers (e.g., ER, general practitioner).

Randomized control trial (RCT) Patients were selected on a sample of days through an entire year, and across all hours of the day. Participants were randomly assigned to the control or intervention group using a computer generated algorithm.

Eligible participants: 900 20 were excluded due to language barrier or unwilling Accepted: 880 patients Control group: 440 enrolled, 40 were unable to be followed up with; 400 patients completed study Intervention group: 440 selected, 45 quit early or were unable to be followed up with; 395 patients completed study

Control group: standard discharge instructions prior to discharge, with no follow-up phone calls Intervention group: standard discharge instructions plus nurse follow-up phone calls: •1st call 1-2 days post discharge •2nd call 4-5 days post discharge

Both dependent variables were assessed via a follow-up phone-based interview 30-days post discharge, using validated questions - both quantitative and open-ended Dependent Variables Health outcome

• affecting daily life

• improvement of conditions

• self-reported health

•consumer satisfaction) Health care utilization

Number of times visiting

• general practitioner

• general outpatient clinic

• ER)

Control and intervention group were not statistically different on demographic characteristics (p>0.05). Intervention group was more likely to report a general "improvement of condition" compared to control group (97% vs. 93%; p=0.026) Intervention group was more likely to report a revisit to the ER within 30-days post discharge compared to control group (30% vs. 24%; p=0.036)

2

Study PICO(T):

For adult patients discharged from the emergency room, does the implementation of two nurse delivered follow-up phone calls post discharge along with standard discharge instructions, compared to standard instructions alone, impact health outcomes and utilization of health care services within 30-days post discharge?