Abstract 12587: Clinical Outcomes of a Nurse-led Post-discharge Education Program for Heart-transplant Recipients

Abstract

Introduction: Heart transplantation is often more limited than other forms of organ transplants, as hearts can only be donated following brain death. Thus, effective discharge education and follow-up management should be provided to achieve successful clinical outcomes after heart transplantation. This study aimed to examine the effects of a nurse-led program with continuous education on outpatient visits with clinical problems and unplanned first rehospitalization, as compared to an existing discharge education. Methods: Participants’ electronic medical records from 2005 to 2018 were retrospectively analyzed. Participants were 136 recipients received heart transplantation operations and discharge education. Participant data were assigned to three groups: usual care (n = 25), nurse-led program without continuous education (n = 66), and nurse-led program with continuous education (n = 45). The usual care was conventional discharge education, provided to all recipients by ward nurses. In the nurse-led program, the transplant coordinator provided education at discharge and telephone response after discharge. The nurse-led program was divided, according to whether recipients received continuous education and counselling on post-heart transplantation care. Follow-up was provided for recipients regarding outpatient visits with clinical problems and unplanned first rehospitalization for 1 year post-transplantation. Results: The nurse-led program with continuous education was found to be associated with significantly reduced outpatient visits with clinical problems, compared to the usual care ( p = 0.001) and nurse-led program without continuous education ( p < 0.001). Compared to the usual care, the nurse-led program with continuous education was associated with a significant reduction in the risk of unplanned first rehospitalization ( p = 0.011). Conclusions: Discharge education provided by a transplant coordinator using a brochure at discharge, and providing telephone responses for problems or questions and continuing education and counselling after discharge, improved post-transplant clinical outcomes. These finding suggest that nurse-led discharge education programs should be implemented after heart transplantation.