PENGEMBANGAN PROTOKOL TRANSITIONAL CARE DI RUANG RAWAT INAP KARDIOVASKULER RSUP H. ADAM MALIK MEDAN
Keywords:
protocol, transitional care, cardiovascular
Abstract
The transitional care protocol is a guide developed as a guide in applying transitional care for patients with congestive heart failure from hospital to home to prevent early readmissions. Goals:This study aims to develop transitional care protocols in Cardiovascular Inpatient Ward at Hospital in Medan. Methods: Action research through two cycles consisting of reconnaissance, planning, action, observation, and reflection used to collect data. Participants consisted of 17 nurses in the cardiovascular ward. Data were analyzed through content analysis and descriptive statistic test. Results: The result of this research was transitional care protocol consist of screening patients at risk of readmissions, patient and family involvement, promoting self management, identification of symptoms and how to overcome them, and nurse collaboration with other health worker in the hospital. Observation results showed that 70.58% of participants were able to do transitional care. increased of nurses' knowledge of transitional care and patient's ready to continuity of care at home. Conclusion: The hospital should monitor and evaluate the implementation of the transitional care protocol and become one of the indicators of the assessment of nurse's performance
References
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Chalermwannapong, S. , Panuthai,S., Srisupan,W., Panya,P., & Ostwald, K. (2010). Effects of the transitional care program on functional ability and quality of life of stroke survivors. Journal National Science, 9(1): 49-66
Comin-Colet, J., Enjuanes, C., Lupon, J., Cainzos-Achirica, M., Badosa, N., & Verdu, J. M. (2016). Transitions of care between acute and chronic heart failure: critical steps in the design of a multidisciplinary care model for the prevention of rehospitalization. Rev Esp Cardiol 69 (10): 951– 961
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Draper, B., Ridley, N., Johnco, C., Withall, A., Sim, W., Freeman, M., . . . Lintzeris, N. (2015). Screening for alcohol and substance use for older people in geriatric hospital and community health settings. International Psychogeriatrics, 27(1), 157-166. doi:10.1017/S1041610214002014
Enguidanos, S., Gibbs, N., & Jamison, P. (2012). From hospital to home: a brief nurse practitioner intervention for vulnerable older adults. Journal Of Gerontological Nursing, 38(3):40–50. doi: 10.3928/00989134-20120116-01
Findley, M. K., Cha, S., Wong, E. , & Faulkner, M. S. (2015). A Systematic Review of Transitional Care for Emerging Adults with Diabetes. Journal of Pediatric Nursing (2015) 30:e47–e62. doi: http://dx.doi.org/10.1016/j.pedn.2015.05. 019
Franks, S.(2015). Transitional care to reduce 30- day heart failure readmissions among the long-term care elderly population. Seton Hall University DNP Final Projects. Paper 7. Diperoleh dari http://scholarship.shu.edu/final-projects
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Hammond, S. (2015). Staying home after discharge: nurse-led versus physician-led transitional care models. Nurse Leader, Vol 13 (3): 66–70.doi: http://dx.doi.org/10.1016/j.mnl.2014.09.0 12
Hirschman, K.B., Shaid, E., McCauley, K., Pauly, M., & Naylor, M. (2015). Continuity of care: the transitional care model. The Online Journal of Issue in Nursing, 20(3). doi: 10.3912/OJIN.Vol20No03Man01
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Kotowycz, M., Cosman, T. L., Tartaglia, T., Afzal, R., Syal, R. P., & Natarajan, M. K. (2010). Safety and feasibility of early hospital discharge in ST-segment elevation myocardial infarction—A prospective and randomized trial in lowrisk primary percutaneous coronary intervention patients (the Safe-Depart Trial). American Heart Journal ( 2010) 159:117
Kralik, D., Visentin, K., & Van-Loon, A. (2006). Transition: a literature review. Journal of Advanced Nursing, Vol. 55 (3): 320-329. doi:10.1111/j.1365-2648.2006.03899.x Li, J.M., Cheng, S., Cai, W., Zhang, Z. , Liu, Q., & Xie, B. (2014). Transitional care for patients with chronic obstructive pulmonary disease. International Journal of Nursign Science I (2014): 157-164
Majid, A. (2010). Analisis faktor-faktor yang berhubungan dengan kejadian rawat inap ulang pasien gagal jantung kongestif di Rumah SakitYogyakarta (Tesis). Depok: Universitas Indonesia
Naylor, M. D., & Keating, S. (2008). Transitional Care: Moving patients from one care setting to another. American Journal Nursing, 108 (9): 58-63
Naylor, M. D., Hirschman, K. B., Hanlon, A. L., Bowles, K. H., Bradway, C., McCauley, K. M., & Pauly, M. V. (2014). Comparison of evidence-based interventions on outcomes of hospitalized, cognitively impaired older adults. Journal of Comparative Effectiveness Research, 3(3), 245-257. doi: http://dx.doi.org/10.2217/cer.14.14 Polit, D. F., & Beck, C. T. (2014). Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia: Wolters Kluwer Health /Lippincott Williams & Wilkins.
Reeves, G. C., Alhurani, A. S., Frazier, S. K., Watkins, J. F., Lennie, T. A., & Moser, D. K. (2015). The association of comorbid diabetes mellitus and symptoms of depression with all-cause mortality and cardiac rehospitalization in patients with heart failure. BMJ Open Diabetes Research & Care, 3 (1), e000077. Rennke, S., & Ranji, S. (2015). Transitional care strategies from hospital to home: a review for the neurohospitalist. The Neurohospitalist 5(1): 35-42. doi: 10.1177/1941874414540683
Riset Kesehatan Dasar (Riskesdas). (2013).Badan Penelitian dan Pengembangan Kesehatan Kementerian RI tahun 2013. Diakses: 19 Desember 2016, dari http://www.depkes.go.id/resources/downl oad/general/Hasil%20Ris kesdas%202013.pdf
Smeltzer, S. (2010). Brunner Suddarth’s Textbook of Medical Surgical Nursing 12nd Ed, Vol 2. Jakarta : EGC
Stauffer, B., Fullerton, C., Fleming, N., Ogola, G. , Herrin, J., Stafford, P. M., & Ballard, D. J. (2011). Effectiveness and cost of a transitional care program for heart failure. Arch Intern MedJournal 171(14):1238- 1243 National Transitions of Care Coalition. (2014).
Transitional care model . Diperoleh dari www.transitionalcare.info/ Wang, S., Zhao, Y., & Zang, X. (2014). Continuing care for older patients during the transitional period. Chinese Nursing Research 1 (2014): 5-13.
Widagdo, F., Karim, D., & Novayellinda, R. (2014). Faktor-faktor yang berhubungan dengan kejadian rawat inap ulang di Rumah Sakit pada pasien CHF (Tesis). Depok: Universitas Indonesia
Ye, Z., Liu, M. , Cai, R., Zhong, M. ,Huang, H., Liang, M.,& Quan, X. (2015). Development of the Transitional Care Model for nursing care in Mainland China: A literature review. International Journal of Nursing Sciences, 3(2016): 113-130
Youn-Jung, S., & Mi-Ae, Y. (2015). Transitional care for older adults with chronic illnesses as a vulnerable population: theoretical framework and future directions in nursing. Journal Korean Academic Nurs, Vol. 45 (6): 919-927. doi: http://dx.doi.org/10.4040/jkan.2015.45.6. 919
Bradway, C., Trotta, R., Bixby, M. B., McPartland, E. , Wollman, M. C., Kapustka, H., . . . Naylor, M. D. (2012). A qualitative analysis of an advanced practice nurse-directed transitional care model intervention. Gerontologist, 52(3), 394-407. doi:10.1093/geront/gnr078
Chalermwannapong, S. , Panuthai,S., Srisupan,W., Panya,P., & Ostwald, K. (2010). Effects of the transitional care program on functional ability and quality of life of stroke survivors. Journal National Science, 9(1): 49-66
Comin-Colet, J., Enjuanes, C., Lupon, J., Cainzos-Achirica, M., Badosa, N., & Verdu, J. M. (2016). Transitions of care between acute and chronic heart failure: critical steps in the design of a multidisciplinary care model for the prevention of rehospitalization. Rev Esp Cardiol 69 (10): 951– 961
Conroy-McCue, D. (2014). Transitional care services: a nurse-led quality improvement project. Doctor of Nursing Practice (DNP) Projects University of San Francisco. Paper 47. Diperoleh dari http://repository.usfca.edu/dnp Dharmarajan, K., Hsieh, A. H., Lin, Z., Bueno, H., Ross, J., Horwitz, L., . . . Krumholz, H. (2013). Diagnoses and timing of 30- day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. JAMA. 2013 January 23; 309(4): 355–363
Donald, F., Kilpatrick, K., Reid, K., Carter, N., Bryant-Lukosius, D., Martin-Misener, R.,. . .
Dicenso, A. (2015). Hospital to community transitional care by nurse practitioners: A systematic review of costeffectiveness. International Journal of Nursing Studies 52 (2015): 436–451. doi: http://dx.doi.org/10.1016/j. ijnurstu.2014.0 7.011
Draper, B., Ridley, N., Johnco, C., Withall, A., Sim, W., Freeman, M., . . . Lintzeris, N. (2015). Screening for alcohol and substance use for older people in geriatric hospital and community health settings. International Psychogeriatrics, 27(1), 157-166. doi:10.1017/S1041610214002014
Enguidanos, S., Gibbs, N., & Jamison, P. (2012). From hospital to home: a brief nurse practitioner intervention for vulnerable older adults. Journal Of Gerontological Nursing, 38(3):40–50. doi: 10.3928/00989134-20120116-01
Findley, M. K., Cha, S., Wong, E. , & Faulkner, M. S. (2015). A Systematic Review of Transitional Care for Emerging Adults with Diabetes. Journal of Pediatric Nursing (2015) 30:e47–e62. doi: http://dx.doi.org/10.1016/j.pedn.2015.05. 019
Franks, S.(2015). Transitional care to reduce 30- day heart failure readmissions among the long-term care elderly population. Seton Hall University DNP Final Projects. Paper 7. Diperoleh dari http://scholarship.shu.edu/final-projects
Graves, B. A., Ford, C. D., & Mooney, K. D. (2013). Telehealth technologies for heart failure disease management in rural areas: an integrative research review. Online Journal of Rural Nursing and Health Care, 13(2). Diakses dari http://rnojournal.binghamton.edu/index.p hp/RNO/article/view/282
Hammond, S. (2015). Staying home after discharge: nurse-led versus physician-led transitional care models. Nurse Leader, Vol 13 (3): 66–70.doi: http://dx.doi.org/10.1016/j.mnl.2014.09.0 12
Hirschman, K.B., Shaid, E., McCauley, K., Pauly, M., & Naylor, M. (2015). Continuity of care: the transitional care model. The Online Journal of Issue in Nursing, 20(3). doi: 10.3912/OJIN.Vol20No03Man01
Kemmis, S. , & R. Mc Taggart. (1988). The action research planner. Victoria: Deakin University.
Kilcup, M., Schultz, D, Carison, J & Wilson, B. (2003). Postdischarge pharmacist medication reconciliation: impact on readmission rates and financial savings. J Am Pharm Assoc (2003). 2013 Jan- Feb;53(1):78-84. doi: 10.1331/JAPhA.2013.11250.
Kotowycz, M., Cosman, T. L., Tartaglia, T., Afzal, R., Syal, R. P., & Natarajan, M. K. (2010). Safety and feasibility of early hospital discharge in ST-segment elevation myocardial infarction—A prospective and randomized trial in lowrisk primary percutaneous coronary intervention patients (the Safe-Depart Trial). American Heart Journal ( 2010) 159:117
Kralik, D., Visentin, K., & Van-Loon, A. (2006). Transition: a literature review. Journal of Advanced Nursing, Vol. 55 (3): 320-329. doi:10.1111/j.1365-2648.2006.03899.x Li, J.M., Cheng, S., Cai, W., Zhang, Z. , Liu, Q., & Xie, B. (2014). Transitional care for patients with chronic obstructive pulmonary disease. International Journal of Nursign Science I (2014): 157-164
Majid, A. (2010). Analisis faktor-faktor yang berhubungan dengan kejadian rawat inap ulang pasien gagal jantung kongestif di Rumah SakitYogyakarta (Tesis). Depok: Universitas Indonesia
Naylor, M. D., & Keating, S. (2008). Transitional Care: Moving patients from one care setting to another. American Journal Nursing, 108 (9): 58-63
Naylor, M. D., Hirschman, K. B., Hanlon, A. L., Bowles, K. H., Bradway, C., McCauley, K. M., & Pauly, M. V. (2014). Comparison of evidence-based interventions on outcomes of hospitalized, cognitively impaired older adults. Journal of Comparative Effectiveness Research, 3(3), 245-257. doi: http://dx.doi.org/10.2217/cer.14.14 Polit, D. F., & Beck, C. T. (2014). Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia: Wolters Kluwer Health /Lippincott Williams & Wilkins.
Reeves, G. C., Alhurani, A. S., Frazier, S. K., Watkins, J. F., Lennie, T. A., & Moser, D. K. (2015). The association of comorbid diabetes mellitus and symptoms of depression with all-cause mortality and cardiac rehospitalization in patients with heart failure. BMJ Open Diabetes Research & Care, 3 (1), e000077. Rennke, S., & Ranji, S. (2015). Transitional care strategies from hospital to home: a review for the neurohospitalist. The Neurohospitalist 5(1): 35-42. doi: 10.1177/1941874414540683
Riset Kesehatan Dasar (Riskesdas). (2013).Badan Penelitian dan Pengembangan Kesehatan Kementerian RI tahun 2013. Diakses: 19 Desember 2016, dari http://www.depkes.go.id/resources/downl oad/general/Hasil%20Ris kesdas%202013.pdf
Smeltzer, S. (2010). Brunner Suddarth’s Textbook of Medical Surgical Nursing 12nd Ed, Vol 2. Jakarta : EGC
Stauffer, B., Fullerton, C., Fleming, N., Ogola, G. , Herrin, J., Stafford, P. M., & Ballard, D. J. (2011). Effectiveness and cost of a transitional care program for heart failure. Arch Intern MedJournal 171(14):1238- 1243 National Transitions of Care Coalition. (2014).
Transitional care model . Diperoleh dari www.transitionalcare.info/ Wang, S., Zhao, Y., & Zang, X. (2014). Continuing care for older patients during the transitional period. Chinese Nursing Research 1 (2014): 5-13.
Widagdo, F., Karim, D., & Novayellinda, R. (2014). Faktor-faktor yang berhubungan dengan kejadian rawat inap ulang di Rumah Sakit pada pasien CHF (Tesis). Depok: Universitas Indonesia
Ye, Z., Liu, M. , Cai, R., Zhong, M. ,Huang, H., Liang, M.,& Quan, X. (2015). Development of the Transitional Care Model for nursing care in Mainland China: A literature review. International Journal of Nursing Sciences, 3(2016): 113-130
Youn-Jung, S., & Mi-Ae, Y. (2015). Transitional care for older adults with chronic illnesses as a vulnerable population: theoretical framework and future directions in nursing. Journal Korean Academic Nurs, Vol. 45 (6): 919-927. doi: http://dx.doi.org/10.4040/jkan.2015.45.6. 919
Published
2019-06-12
How to Cite
Siallagan, A. (2019). PENGEMBANGAN PROTOKOL TRANSITIONAL CARE DI RUANG RAWAT INAP KARDIOVASKULER RSUP H. ADAM MALIK MEDAN. Elisabeth Health Jurnal, 4(1), 6-16. https://doi.org/10.52317/ehj.v4i1.252
Section
Articles
