Peds SM-THINk: Nursing Interventions to Improve Discharge Outcomes

NCT03539978 | Completed

• 1 other identifier: 1118599
• Study Type: observational
• Target: 486
• Locations: 1 country
• Sites: 1

Brief Summary

This study focuses on the delivery of discharge education by clinical nurses to improve parent and family self-management in the home environment. This study tests an discharge method (SM-THINk protocol) designed to improve the quality of care for hospitalized pediatric patients at the time of discharge, enhance the child's and family's experience, and decrease length of stay and health care utilization (ED visit or re-admission). The SM-THINk protocol is an enhancement to the standard clinical practice and will be implemented for all subjects on two Children's Hospital of Wisconsin (CHW) nursing units. This enhancement will require additional training of the nurses prior to implementation of the research project. This research determines the effectiveness of the training enhanced discharge method. The training is independent from the research project and will evaluate effectiveness of this training. For the enhanced discharge method, clinical nurses on the study units will be trained to deliver the Self-Management Transition to Home (SM-THINk protocol), which is based on the family self-management discharge preparation previously developed and tested by the study team.

Conditions

Pediatric ALL

Outcome Measures

Primary Outcomes (1)

• Improved parent experience

  Parents of children with and without complex or chronic health conditions who received enhanced discharge preparation by the clinical nurse using the SM-THINk protocol would report increased parent experience (quality of discharge teaching delivered and care coordination).

  30 days

Study Arms (2)

SM-THINk Unit

Two of the three inpatient floors will use the SM-THINk enhanced discharge method. This is part of a clinical practice change and not for research. Parents will complete a questionnaire at the time of the patient's discharge from the hospital.

Other: SM-THINk

Control Unit

One of the three inpatient floors will use the usual discharge method. Parents will also complete a questionnaire at the time of the patient's discharge from the hospital.

Interventions

SM-THINk OTHER

Patients will receive the SM-THINk enhanced discharge method.

SM-THINk Unit

Eligibility Criteria

• Age: Up to 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

We expect to enroll 300 patients and one legal guardian per patient (parent or caregiver who has guardianship of the patient) per unit (for a total of 900 patients and 900 parents). A high-risk discharge assessment based on Mayo Clinic criteria will be used to identify children with complex or chronic conditions. Based on conversations with hospital leadership it is expected that approximately 120 patients per unit (40%) will have a complex or chronic condition. Parent experience related to quality of discharge teaching and care coordination will be self-reported by parents using established, reliable and valid scales. Child and parent characteristics, length of hospitalization, readmission, and Emergency Department use data will be extracted from electronic medical records.

You may qualify if:

• the parent's/caregiver's child is inpatient on the selected study units
• the parent/caregiver is English speaking (to date the tools being used have been validated for English participants only)
• the parent/caregiver is 18 years of age or older
• the patient is 17 years of age or younger

You may not qualify if:

• presence of significant communication or cognitive impairment on the part of the parent/caregiver that would preclude completion of questionnaires based on self-report.
• the patient is a ward of the state or in foster care

Sponsors & Collaborators

• Medical College of Wisconsin: lead
• Clinical & Translational Science Institute: collaborator
• Marquette University: collaborator
• Children's Hospital and Health System Foundation, Wisconsin: collaborator
• University of Wisconsin, Milwaukee: collaborator

Study Sites (1)

Children's Hospital of Wisconsin

Milwaukee, Wisconsin, 53226, United States

Location

MeSH Terms

Conditions

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Condition Hierarchy (Ancestors)

Leukemia, Lymphoid; Leukemia; Neoplasms by Histologic Type; Neoplasms; Hematologic Diseases; Hemic and Lymphatic Diseases; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Immune System Diseases

Study Officials

• Stacee Lerret, PhD

  Medical College of Wisconsin

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: April 25, 2018
• First Posted: May 30, 2018
• Study Start: August 30, 2018
• Primary Completion: February 20, 2019
• Study Completion: April 20, 2019
• Last Updated: December 12, 2019

Record last verified: 2019-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)