Date of Award

Summer 2022

Project Type

Thesis

College or School

CHHS

Department

Nursing

Degree Name

Master of Science

First Advisor

Dr. Elizabeth Evans

Second Advisor

Dr. Pamela Kallmerten

Abstract

Background: Without a clear understanding of proper discharge instructions or a lack of educational material, patients may leave the hospital feeling conflicted as to what to do. In 2021 a research study noted that patients who do not have enough information prior to discharge have decreased compliance, decreased patient safety, increased risk of hospital readmission, and poor overall satisfaction (DeSai, Janowiak, Secheli, et. al., 2021). This quality improvement project sought to increase patient knowledge related to exercise and nutrition following a cardiovascular event that led to a hospital admission.

Methods: For the purpose of this quality improvement project, the PDSA or Plan, Do, Study, Act framework was used to guide this quality improvement intervention. This project took place on the Intermediate Care Unit [IMCU]. The unit includes a Cardiovascular Step-Down Unit which is where the patients who are included in this project were admitted.

Interventions: This intervention included the use of an educational pamphlet that focuses on nutrition and exercise recommendation for patients who were admitted following a cardiovascular event. For the purpose of this quality improvement project the cardiovascular events that are included are myocardial infarction, and coronary artery bypass graft surgery. All patients over the age of eighteen, both male and female, were included in this project. Patients with cognitive impairments or who do not fit the inclusion criteria were excluded from the intervention. At the time of admission, a paper survey was given to those patients that fit the inclusion criteria. Patients were asked questions related to their own perception of exercise and nutrition.

Results: Twenty patients were surveyed and given educational material to review. Out of twenty patients, only twelve understood the definition of the “Heart Healthy” diet prior to the review of educational materials. After the review, eighteen out of twenty, or 90% of patients were able to recall the correct definition of the “Heart Healthy” diet. This shows a greater than 25% increase in patient knowledge in relation to nutrition guidelines. This quality improvement project was able to provide patients with educational materials and discharge information related to nutrition and exercise. The results of the survey did show an understanding of nutrition and exercise guidelines in relation to cardiovascular health following an open-heart cardiovascular surgery. The aim of this project was to increase patient understanding by at least 25% from the baseline. Although not all measures that were surveyed increased by 25%, most measures signified at least a 10% increase in patient understanding of exercise and nutrition guidelines.

Conclusion: The results of the project showed an increased understanding in exercise, and nutrition, after a cardiovascular event. This project is useful for organizations as it can increase patient understanding, patient satisfaction, and could possibly decrease the likelihood of patient readmissions due to increased knowledge on health promotion. For this project to continue, stakeholders on the unit must engage and provide the educational pamphlet and materials to patients prior to discharge. If this occurs frequently, the HCAHPS measures can be monitored, by unit, to see if patient understanding and satisfaction has increased. The next steps of this project are to continue to educate patients on nutrition and exercise by providing educational materials that patients can utilize at home after discharging from the organization.

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