Hospital to Home Outcomes
- Conditions
- Focus: Hospitalized Patients
- Interventions
- Other: Standard of CareOther: Nurse Home Visit
- Registration Number
- NCT02081846
- Lead Sponsor
- Children's Hospital Medical Center, Cincinnati
- Brief Summary
Home Nurse Visit post discharge.
- Detailed Description
To identify barriers to successful transitions that are most meaningful to patients and families, and use these identified barriers to iteratively adapt an existing nurse home visit program to address these barriers. This study will also test the efficacy of a nurse home visit intervention in improving post-discharge outcomes through a randomized controlled trial.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1500
- Patient is under 18 years of age Patient is admitted to Cincinnati Children's Hospital Medical Center to hospital medicine, community pediatrics, adolescent medicine, neurology or neurosurgery.
- Patient to be discharged someplace other than home (e.g., residential facility, psychiatric facility)
- Patient's home residence is outside the home nursing service area
- Patient is eligible for "traditional" home nursing services
- Caregiver is non-English speaking
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control Standard of Care This arm will receive standard of care. Home Nurse Visit Nurse Home Visit Families in this arm will receive a nurse home visit within 96 hours of discharge.
- Primary Outcome Measures
Name Time Method Number of Participants With Any Occurrence of Unplanned Re-hospitalization and/or Any Emergency/Urgent Care Visits Within 30 Days of Hospital Discharge 30 days post-discharge The dependent variable will be a dichotomized indicator of any occurrence of unplanned rehospitalization and/or any emergency department/urgent care visit within 30-days post-discharge (i.e. unplanned reutilization). Differences in this outcome between intervention and control groups will be evaluated using logistic regression with the stratification variables (neighborhood poverty and complex versus noncomplex teams) included in the model.
- Secondary Outcome Measures
Name Time Method Post Discharge Coping Difficulty Scale 14 days post-discharge Post-Discharge Difficulty Coping Scale (Weiss, et. al) measured at 14 day post-discharge phone call. Post-Discharge Coping Difficulty Scale uses an 11 point scaling format (0-10) with total scores ranging from 0 to 100. Higher scores represent greater coping difficulty.
Days Until Normalcy 14 days post-discharge Number of days until normalcy: measured at post discharge phone call. Parents asked to recall the number of days it took to "return to a 'normal' routine" including the return to work and school (with option of not yet be back to normal).
Red Flags Remembered 14 days post-discharge This was measured at the 14 day post-discharge phone call survey. Parents were asked to recall "any red flags or warning signs" to indicate the "child's condition was getting worse." The number of red flags recalled could range from 0-10 depending on the template used. The template was a home visit guideline for nurses to use that was specific to the child's illness. For example, if the child had bronchiolitis the nurse would use the template "bronchiolitis/croup/pneumonia" to guide them through the visit. Higher values (i.e., the greater number of red flags remembered) represent a better outcome.
Number of Participants With Occurrence(s) of an Unplanned Readmission Within 30 Days Post-discharge 30 days Occurrence(s) of an unplanned readmission within 30 days post-discharge.
Number of Participants With Occurrence(s) of an Emergency Department Visit Within 30 Days Post-discharge 30 days Occurrence(s) of an ED visit within 30 days post-discharge
Number of Participants With Occurrence(s) of 14-day Unplanned Healthcare Utilization 14 days post-discharge Occurrence(s) of 14-day unplanned healthcare utilization defined by unplanned re-hospitalization and/or any emergency/urgent care visit within 14 days or parent report of an unplanned visit to one of these places. Parent report is collected at the 14 day follow-up phone call.
Trial Locations
- Locations (1)
Cincinnati Children's Hospital Medical Center
🇺🇸Cincinnati, Ohio, United States