Personalised discharge care planning for postmyocardial infarction patients through the use of the Personalised Patient Education Protocol - implementing theory into practice

• Published in: Journal of clinical nursing Vol. 25; no. 9-10; pp. 1292 - 1300
• Main Authors: Lau-Walker, Margaret, Landy, Anne, Murrells, Trevor
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.05.2016; Wiley Subscription Services, Inc
• Subjects: Delivery of Health Care; Evidence-based nursing; Female; Heart attacks; Humans; Interviews as Topic; Male; Middle Aged; Models, Nursing; Myocardial Infarction - nursing; Myocardial Infarction - psychology; Myocardial Infarction - rehabilitation; Nursing; Patient care planning; Patient Discharge; Patient education; Patient Education as Topic; patient participation; patient voice; patient-centred care; Quality of Life; Surveys and Questionnaires; United Kingdom > UK; England; patient participation; patient-centred care; patient voice
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.13177

Aims and objectives This study aims to evaluate the service impact of the integration of an evidence‐based instrument – the Personalised Patient Education Protocol – into an existing postmyocardial infarction care pathway. Background Recent research indicates that while better patient health outcomes can be achieved when care planning is personalised, delivery staff feel less satisfied and less confident in its provision. To achieve a shift to personalised care, innovations are needed to enable an effective transition for staff. Design A service evaluation using a patient survey and nurse interviews. Method A longitudinal patient survey measured changes in patient illness beliefs, cardiac diet and exercise self‐efficacy, anxiety, depression and quality of life study of a patient cohort of 74. Paired t‐tests analysed the effects before and after the implementation of the Personalised Patient Education Protocol. Cardiac rehabilitation nurses who implemented the Personalised Patient Education Protocol were interviewed and a patient survey identified perceptions of the usefulness of the service innovation. Results Analysis of change from baseline to three months results showed statistically significant changes in Illness Belief component ‘Understanding’ and the Dartmouth Quality of Life ‘General Health’. The integration of the Personalised Patient Education Protocol into the existing discharge process identified service improvements for cardiac nurse training and care pathway delivery, while patients identified the level and frequency of their use of the protocol following discharge. Conclusion The introduction of the Personalised Patient Education Protocol succeeded in increasing patient engagement, facilitated a more patient‐centred service by enabling practitioners to systematically provide personalised patient education, and gave patients a postdischarge structure to better follow‐up their illness concerns with health professionals in the community. Relevance to clinical practice Integration of the Personalised Patient Education Protocol into an existing postmyocardial infarction care pathway enabled nurses to systematically respond to individual patients’ illness beliefs and expectations.