J Korean Acad Nurs.  2014 Apr;44(2):228-236. 10.4040/jkan.2014.44.2.228.

Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease

• Kim SW
• Uhm JY
• Im YM
• Yun TJ
• Park JJ
• Park CS

• KMID: 1791853
• DOI: http://doi.org/10.4040/jkan.2014.44.2.228

Abstract

PURPOSE
Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality.
METHODS
Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge.
RESULTS
Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (chi2=1.15, p=.283).
CONCLUSION
Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.

Keyword

Telenursing; Congenital heart defects; Pediatric cardiac surgery; Home monitoring

MeSH Terms

Body Temperature
Body Weight
Caregivers/education/psychology
Counseling
Female
Heart Defects, Congenital/mortality/prevention & control/*surgery
Heart Rate
Hospitalization
Hotlines
Humans
Infant
Infant, Newborn
Male
Monitoring, Physiologic/*methods
Oxygen Consumption
Palliative Care
*Program Evaluation
Prospective Studies
Time Factors

Figure

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  Figure 1 Hotline triage protocol.

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  Figure 2 Primary outcome of death.

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