Abstract
The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected by global positioning systems (GPS). Participants were asked to carry the tracking applications (apps) for 30–90 days. Eighteen participants were recruited (6 metropolitan 12 rural) 61% ST elevation myocardial infarction (STEMI), mean age 55 years, 83% male. Recall of discharge education included knowledge of diagnosis (recall = 100%), procedures (e.g., angiogram = 40%), and comorbidities (e.g., hypertension = 60%, diabetes = 100%). In the first 30 days post-discharge, median steps per day was 2506 (standard deviation (SD) ± 369) steps (one participant completed 10,000 steps), 62% visited a general practitioner (GP) 16% attended cardiac rehabilitation, 16% visited a cardiologist, 72% a pharmacist, 27% visited the emergency department for cardiac event, and 61% a pathology service (blood tests). Adherence to using the activity tracking apps was 87%. Managing Big Data from the GPS and physical activity tracking apps was a challenge with over 300,000 lines of raw data cleaned to 90,000 data points for analysis. This study was an example of the application of objective data from the real world to help understand post-ACS discharge patient activity. Rates of access to services in the first 30 days continue to be of concern.
Highlights
There has been considerable interest from hospitals and clinicians to better understand and improve modifiable factors associated with 30-day hospital readmissions [1,2,3,4,5]
Reasons for exclusion included: admitted previously with acute coronary syndrome (ACS) (37% of the total and 16 of the potential Aboriginal people screened); people who declined to participate (10%); cognitive impairment (6%); awaiting surgery or review (5%) and other included being enrolled in another study (41%)
The mean accuracy of global positioning systems (GPS) captured data points was at 16.2 m compared to the mean accuracy of satellite-captured data which was within 1832.7 m
Summary
There has been considerable interest from hospitals and clinicians to better understand and improve modifiable factors associated with 30-day hospital readmissions [1,2,3,4,5]. Hospitalized patients commonly become deconditioned during hospitalisation and, as a result, often develop impaired stamina, coordination, and strength, which place them at greater risk for accidents and falls [3]. These limitations may diminish their ability to adhere to post-discharge instructions such as the capacity to resume basic activities or attend follow-up appointments. Most of the identified risk factors for 30-day readmissions are not readily modifiable (i.e., socioeconomics and comorbidities) understanding the gaps that exist in current post-discharge education practices will improve outcomes [1,2,3,4,5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
