Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study.
Impact of a nurse-led teleconsultation strategy for cardiovascular disease management during COVID-19 pandemic in India: a pyramid model feasibility study.
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DOI：
10.1136/bmjopen-2021-056408
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发表时间：
2022-07-07
期刊：
影响因子：
2.9
通讯作者：
Prabhakaran, Dorairaj
中科院分区：
文献类型：
--
作者：
Mohan, Bishav;Singh, Bhupinder;Singh, Kavita;Naik, Nitish;Roy, Ambuj;Goyal, Abhishek;SIngh, Gurbhej;Aggarwal, Shivaansh;Saini, Aftabh;Tandon, Rohit;Chhabra, Shibba Takkar;Aslam, Naved;Wander, Gurpreet Singh;Prabhakaran, Dorairaj
2019冠状病毒病大流行需要使用远程医疗来维持心血管疾病患者的护理连续性。本研究旨在证明在印度COVID-19大流行期间实施护士主导的CVD管理远程会诊策略的可行性，并评估护士主导的远程会诊对患者治疗满意度的影响。我们开发了一个两阶段的远程会诊策略，并测试了实施护士主导的远程会诊策略，以管理CVD在印度的北方州（旁遮普）的可行性。一个多学科的专家小组制定了用于远程咨询的治疗方案，以管理CVD。对护士进行了培训，以提供远程咨询、病人分类和向医生转诊。2019年9月至2020年3月期间在印度卢迪亚纳Dayanand医学院医院门诊或住院的CVD患者通过电话联系并提供远程咨询。远程医疗战略包括：第1阶段护士主导的远程会诊和第2阶段医生主导的远程会诊。进行描述性分析，以报告两阶段远程医疗策略分流的患者比例，以及患者的临床特征，以及护士主导与医生主导的远程会诊之间的治疗满意度。总体而言，护士领导的第1阶段远程会诊提供给12 042例CVD患者。参与者的平均（SD）年龄为58.9岁（12.8岁），男性占65.4%。相对较小比例的患者（6.3%）被转诊接受第2阶段医生主导的远程会诊，其中只有8.4%需要住院治疗。在第1阶段护士主导的远程会诊中，患者因未控制的糖尿病（24.9%）、未控制的高血压（18.7%）和充血性心力衰竭（16.2%）而被转诊给医生。患者的治疗满意度在护士主导与医生主导的远程会诊之间相似（p=0.07）。这项研究表明，护士领导的远程医疗策略是可行的，实施在资源有限的设置分流心血管疾病患者，并减少医生的负担。
The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic in India and evaluated the impact of nurse-led teleconsultations on patient treatment satisfaction. We developed a two-stage teleconsultation strategy and tested the feasibility of implementing a nurse-led teleconsultation strategy to manage CVD in a northern state (Punjab) in India. A multidisciplinary team of experts developed the treatment protocol used for teleconsultations to manage CVD. Nurses were trained to provide teleconsultation, triaging of patients and referrals to the physicians. Patients with CVD who had an outpatient visit or hospitalisation between September 2019 and March 2020 at the Dayanand Medical College Hospital, Ludhiana, India, were contacted by phone and offered teleconsultations. Telemedicine strategy comprised: stage 1 nurse-led teleconsultations and stage 2 physician-led teleconsultations. Descriptive analysis was performed to report the proportion of patients triaged by the two-stage telemedicine strategy, and patient’s clinical characteristics, and treatment satisfaction between the nurse-led versus physician-led teleconsultations. Overall, nurse-led stage 1 teleconsultations were provided to 12 042 patients with CVD. The mean (SD) age of the participants was 58.9 years (12.8), and men were 65.4%. A relatively small proportion of patients (6.3%) were referred for the stage-2 physician-led teleconsultations and of these only 8.4% required hospitalisations. During stage 1 nurse-led teleconsultations, patients were referred to the physicians due to uncontrolled diabetes (24.9%), uncontrolled hypertension (18.7%) and congestive heart failure (16.2%). The patient’s treatment satisfaction was similar between the nurse-led versus physician-led teleconsultations (p=0.07). This study showed that a nurse-led telemedicine strategy is feasible to implement in a resource-constraint setting for triaging patients with CVD and reduces physician’s burden.
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影响因子：
82.9
作者：
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