The Effect of Visual Sternal Precautions on Behavioral Intentions and Readmissions
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/13/2015 |
| Start Date: | August 2014 |
| Contact: | Craig D Feinman, Doctor of Physical Therapy |
| Email: | CFeinman@NSHS.edu |
| Phone: | 5165624710 |
Sternal precautions are standard patient education protocol disseminated to post-operative
open heart surgery patients . While this "best practice" safety measure is widely
distributed to patients, the origin of said precautions is unknown. Statewide hospitals
vary on their parameters for sternal precautions using a myriad of restrictions, i.e.
weighted activities, biomechanical movements to be avoided. In addition, the medium in
which sternal precautions are taught varies, thus complicating patient adherence to these
vital post-operative measures.
The primary objective of this study is to use a randomized pre-post test design to compare
two different training procedures. One training group examines current standard of care
(providing verbal instruction using teach back and written sternal precautions). The second
training group provides subjects with visual depiction of sternal precautions, in addition
to standard of care. The study will analyze 30 and 60 day readmission rates for
aforementioned patients. Finally, the study will assess changes in behavior intentions from
before training to after training in both groups via behavioral analysis survey consisting
of 8 questions.
Hypothesis 1: The investigators hypothesize that subjects provided with visual sternal
precautions, in addition to standard of care, will have a lower 30 and 60 day readmission
rate when compared to subjects in the standard of care group
Hypothesis 2: The investigators hypothesize that changes in behavior intentions toward
sternal precautions will be greater from before training to after training in the visual SPs
in addition to standard of care group than the standard of care only group.
open heart surgery patients . While this "best practice" safety measure is widely
distributed to patients, the origin of said precautions is unknown. Statewide hospitals
vary on their parameters for sternal precautions using a myriad of restrictions, i.e.
weighted activities, biomechanical movements to be avoided. In addition, the medium in
which sternal precautions are taught varies, thus complicating patient adherence to these
vital post-operative measures.
The primary objective of this study is to use a randomized pre-post test design to compare
two different training procedures. One training group examines current standard of care
(providing verbal instruction using teach back and written sternal precautions). The second
training group provides subjects with visual depiction of sternal precautions, in addition
to standard of care. The study will analyze 30 and 60 day readmission rates for
aforementioned patients. Finally, the study will assess changes in behavior intentions from
before training to after training in both groups via behavioral analysis survey consisting
of 8 questions.
Hypothesis 1: The investigators hypothesize that subjects provided with visual sternal
precautions, in addition to standard of care, will have a lower 30 and 60 day readmission
rate when compared to subjects in the standard of care group
Hypothesis 2: The investigators hypothesize that changes in behavior intentions toward
sternal precautions will be greater from before training to after training in the visual SPs
in addition to standard of care group than the standard of care only group.
Eligible subjects will be identified by the Senior Cardiothoracic Physical Therapist (Dr.
Craig D. Feinman, PT, DPT) on staff at North Shore University Hospital. Dr. Feinman will
provide basic study information to potential subjects and refer those that are interested in
the study to the research team who will then provide a copy of the consent form and more
information about the study. Inclusion Criteria represents post-surgical adult patients who
had a median or midline sternotomy incision during cardiac surgery at North-Shore University
Hospital. Exclusion Criteria represents patients with dementia or those that are
cognitively impaired will be excluded from the study.
A T-test or Mann Whitney U test will be use to compare group differences on continuous
variables, e.g. age. Beta regression or logistic regression model will be developed for the
outcomes of adherence and readmission proportions/rates. To assess changes from pre to post
training on behavioral intentions a paired t-test or Wilcoxon signed rank for matched pairs
will be used. A result will be considered statistically significant at the p<0.05 level of
significance. All analyses will be performed using SAS version 9.3 (SAS Institute, Cary,
NC).
Craig D. Feinman, PT, DPT) on staff at North Shore University Hospital. Dr. Feinman will
provide basic study information to potential subjects and refer those that are interested in
the study to the research team who will then provide a copy of the consent form and more
information about the study. Inclusion Criteria represents post-surgical adult patients who
had a median or midline sternotomy incision during cardiac surgery at North-Shore University
Hospital. Exclusion Criteria represents patients with dementia or those that are
cognitively impaired will be excluded from the study.
A T-test or Mann Whitney U test will be use to compare group differences on continuous
variables, e.g. age. Beta regression or logistic regression model will be developed for the
outcomes of adherence and readmission proportions/rates. To assess changes from pre to post
training on behavioral intentions a paired t-test or Wilcoxon signed rank for matched pairs
will be used. A result will be considered statistically significant at the p<0.05 level of
significance. All analyses will be performed using SAS version 9.3 (SAS Institute, Cary,
NC).
Inclusion Criteria:
- Post-surgical adult patients who had a median or midline sternotomy incision during
cardiac surgery at North-Shore University Hospital.
Exclusion Criteria:
- Patients with dementia or those that are cognitively impaired will be excluded from
the study.
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