THE EFFECT OF NURSING COORDINATED CARE DELIVERY ON PATIENT EMPOWERMENT AND SELECTED CLINICAL OUTCOMES (CORONARY BYPASS SURGERY).
Contributors: University of Cincinnati.
Published: 1996
Number of pages: 211
Subjects: Health Sciences, Nursing.; Business Administration, Management.; Health Sciences, Health Care Management.
Description: The purposes of this study were to: (a) assess the effect of care coordination on patient empowerment, (b) determine the relationship between the patient's level of empowerment prior to surgery and the accomplishment of discharge recovery outcomes, (c) determine if empowerment and specific physiological variables were significant predictors of length of stay (LOS) after surgery, and (d) describe selected clinical recovery outcomes that may have been influenced by care coordination. The theoretical/conceptual framework for this study was based on empowerment models and assumptions, extant nursing coordinated care delivery models, outcomes research related to coordinated care, and recent research related to individual empowerment. The researcher hypothesized that coordination of care, through the implementation of a unit-based structure and through the use of CareMaps(tm), would facilitate the development of empowerment and the achievement of recovery goals of coronary artery bypass graft (CABG) patients.

A descriptive-comparative pretest-posttest design was used in this study. The 120 CABG patients that were included in the study were designated into one of two groups (n = 60 patients per group) for the data analysis process, depending upon whether their care was coordinated through the use of a regular recovery or rapid recovery CareMap(tm). The empowerment level of patients in both groups was measured prior to surgery and at discharge through the use of a 16-item instrument.

Results of the study revealed that coordination of care can influence recovery outcomes for CABG patients. Patients in the rapid recovery group had a significantly shorter ventilator time, critical care unit LOS, and postoperative LOS than did regular recovery patients. Empowerment level was not found to be correlated with LOS or accomplishment of CareMap(tm) recovery outcomes. Predictors of LOS included complications after surgery, time on the ventilator after surgery, gender, and number of bypass grafts. The empowerment level of patients did not change significantly from prior to surgery to the time of discharge, but patients in the rapid recovery group had a significantly overall higher empowerment level than did regular recovery patients. The empowerment instrument used in this study was found to have good overall reliability and construct validity.
Notes: Source: Dissertation Abstracts International, Volume: 57-06, Section: B, page: 3654.

Thesis (PH.D.)--UNIVERSITY OF CINCINNATI, 1996.

School code: 0045.