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IRCT20100531004062N2 IRCT 2021-08-02 Tehran University of Medical Sciences The effect of the‏ designed ‏transitional care plan from the Open Heart Intensive Care Unit to the general ward in patients undergoing coronary artery bypass graft surgery The effect of the‏ designed ‏transitional care plan from the Open Heart Intensive Care Unit to the general ward in patients undergoing coronary artery bypass graft surgery 2021-09-23 anticipated 62 Complete https://irct.ir/trial/57664 interventional Randomization: Not randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Health service research, Other design features: This study is part of a mixed-method study that aims to design, implement and evaluation of the‏ ‏transitional care plan‏ ‏from OH-‏ICU to general ward; The result of the doctoral dissertation of Nursing, Tehran University of Medical Sciences, School of Nursing and Midwifery, Number: 961199997. In order to design a transitional care program, while examining the concept of transitional care from the perspective of stakeholders (patients, patient companions, physician, and nurse responsible for patient transfer), the needs of patients undergoing CABG surgery eligible for transfer to the general ward have been identified (qualitative study). The program takes into account the preferences and needs of patients and stakeholders, using the best available evidence (systematic review of literature, guidelines, protocols, programs, and models of transitional care over the past 10 years), and the opinions of the Experts panel (Focus group) to be designed. Finally, the transitional care program was designed and developed in four dimensions: 1- Transfer expectation 2- Support, gradual reduction of dependence and increase of independence 3- Communication and strengthening of Care triangle 4- continuity of Integrated and need-based care. N/A Transitional care program for patients undergoing coronary artery bypass graft surgery from the open heart intensive care unit to the general ward. Intervention 1: Intervention group: after the necessary explanations to the ‎research samples and obtaining informed consent, before ‎transferring the patient from the open heart surgery-intensive ‎care unit, questionnaires related to the expected outcomes ‎‎(anxiety and perceived social support) are completed. Patients ‎then have a transitional care program that includes measures ‎designed to transfer the patient from the physician's decision ‎to transfer the patient from the open heart surgery-intensive ‎care unit to discharge from the general ward, which is ‎designed to maintain the continuity of the integrated care while ‎transferring the patient. It is performed in a multidisciplinary ‎manner and with the cooperation of the patient, the patient ‎care nurses from the open heart intensive care unit and ‎general care, and the physician with the participation of the ‎patient companions (friend, spouse, or relatives). Interventions ‎are performed by trained nurses to implement this program in ‎the intensive care unit and the general ward. The researcher ‎monitors and tracks the patient and the implementation of the ‎program during the course and records how the program is ‎implemented in the registration forms of the transitional care ‎program. On the day of the patient's discharge, questionnaires ‎related to the expected outcomes (perceived anxiety and social ‎support, patient satisfaction, and family satisfaction) are ‎completed. ‎. Intervention 2: Control group: after the necessary explanations to the research samples and obtaining informed consent, before transferring the patient from the open heart surgery-intensive care unit of , questionnaires related to the expected outcomes (anxiety and perceived social support) are completed. Patients then receive routine care during the transfer to the general ward until the day of discharge. The researcher follows the patient throughout the course to be excluded from the study if they meet the exclusion criteria.On the day of the patient's discharge, questionnaires related to the expected outcomes (perceived anxiety and social support, patient satisfaction and family satisfaction) arecompleted. Yes - There is a plan to make this available What will be shared: The data file, participants' details, information about the outcomes, and the study protocol with the designed program will be published as an articles When: 6 months after publishing the results To whom: For researchers working in academic institutions with the approval of supervisors and advisors Conditions: Only for use of the designed program with cited to the source Where to obtain: The main researcher, Ms. Sahar Khoshkasht How to obtain: Send email to supervisors Dr. Masoumeh ZakeriMoghadam and Dr. Shahrzad Ghiyasvandian Comments:
public Sahar Khoshkesht
School of Nursing & Midwifery, Tehran University of Medical Sciences, Nosrat St., Tohid Sq.
Tehran Iran (Islamic Republic of) ‎1419733171‎ +98 21 6105 4000 khoshkesht@razi.tums.ac.ir Tehran University of Medical Sciences scientific Masoumeh Zakerimoghadam
School of Nursing & Midwifery, Tehran University of Medical Sciences, Nosrat St., Tohid Sq.
Tehran Iran (Islamic Republic of) 1419733171 +98 21 6105 4000 zakerimo@tums.ac.ir Tehran University of Medical Sciences Iran (Islamic Republic of) All patients undergoing Coronary artery bypass graft(CABG) surgery who are candidates for transfer from the Open Heart Intensive Care Unit (OH-ICU) to the general ward at least two days after surgery as directed by the physician Level of consciousness 15 according to Glasgow Coma Scale (GCS) No chronic progressive disease or acute unpredicted complications of surgery No history of diagnosed psychological disorders 18 years no limit Both Reluctance to continue participating in the study during the intervention Death of the patient The occurrence of an unpredictable accident that interferes with the implementation of the program I25.7 Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris N/A N/A Intervention group: after the necessary explanations to the ‎research samples and obtaining informed consent, before ‎transferring the patient from the open heart surgery-intensive ‎care unit, questionnaires related to the expected outcomes ‎‎(anxiety and perceived social support) are completed. Patients ‎then have a transitional care program that includes measures ‎designed to transfer the patient from the physician's decision ‎to transfer the patient from the open heart surgery-intensive ‎care unit to discharge from the general ward, which is ‎designed to maintain the continuity of the integrated care while ‎transferring the patient. It is performed in a multidisciplinary ‎manner and with the cooperation of the patient, the patient ‎care nurses from the open heart intensive care unit and ‎general care, and the physician with the participation of the ‎patient companions (friend, spouse, or relatives). Interventions ‎are performed by trained nurses to implement this program in ‎the intensive care unit and the general ward. The researcher ‎monitors and tracks the patient and the implementation of the ‎program during the course and records how the program is ‎implemented in the registration forms of the transitional care ‎program. On the day of the patient's discharge, questionnaires ‎related to the expected outcomes (perceived anxiety and social ‎support, patient satisfaction, and family satisfaction) are ‎completed. ‎ Control group: after the necessary explanations to the research samples and obtaining informed consent, before transferring the patient from the open heart surgery-intensive care unit of , questionnaires related to the expected outcomes (anxiety and perceived social support) are completed. Patients then receive routine care during the transfer to the general ward until the day of discharge. The researcher follows the patient throughout the course to be excluded from the study if they meet the exclusion criteria.On the day of the patient's discharge, questionnaires related to the expected outcomes (perceived anxiety and social support, patient satisfaction and family satisfaction) arecompleted. Patients Satisfaction. Timepoint: After the intervention. Method of measurement: Patients Satisfaction Instrument. Family Satisfaction. Timepoint: After the intervention. Method of measurement: Family Satisfaction Questionnaire. Anxiety. Timepoint: Before and after the intervention. Method of measurement: Speilberger State – Trait Anxiety Inventory (STAI-Y)‎. Relocation Stress Syndrome. Timepoint: After the intervention. Method of measurement: Relocation Stress Syndrome Scale. Total Comfort Score. Timepoint: Before and after the intervention. Method of measurement: Visual Analog Scale to Total Comfort. Tehran University of Medical Sciences Approved 2019-05-19 ‎ ‎Joint institutional research ‎ethics Committee of School of Nursing and Midwifery ‎& ‎Rehabilitat Nosrat St., Tohid Sq., School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehra, Iran Tehran Tehran Iran (Islamic Republic of)