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Evid Based Nurs 3:56 doi:10.1136/ebn.3.2.56
  • Treatment

The addition of a home visit by a cardiac nurse to usual multidisciplinary care reduced deaths and readmissions in patients with chronic congestive heart failure


 
 QUESTION: In patients with chronic congestive heart failure (CHF) who are discharged home after acute admission, does the addition of a home visit by a cardiac nurse to usual multidisciplinary care reduce out of hospital deaths and unplanned readmissions?

Design

Randomised (concealed), blinded (outcome assessor), controlled trial with 6 months of follow up.

Setting

A tertiary referral hospital in Adelaide, South Australia, Australia.

Patients

200 patients ≥55 years of age (mean age 76 y, 62% men) who were to be discharged home, had CHF, and had ≥1 previous admission for acute CHF. Exclusion criteria were reversible ischaemia precipitating heart failure, valvular heart disease amenable to surgery, intended heart transplantation, terminal illness, or residence outside of the catchment area. Follow up was complete.

Intervention

100 patients were allocated to usual discharge care (appointment with primary care physician and/or cardiology outpatient clinic within 2 weeks of discharge and contact with a cardiac rehabilitation nurse, dietician, …