Augmenting Atrial Fibrillation Care After an Emergency Department Visit: Implementing Telephone Practice

J Nurs Care Qual. 2019 Oct/Dec;34(4):337-339. doi: 10.1097/NCQ.0000000000000381.

Abstract

Background: Between 2010 and 2012, the Heart Rhythm team in a tertiary care hospital completed a retrospective study that found that atrial fibrillation (AF) care can be episodic and heavily reliant on hospital resources, particularly the emergency department (ED).

Problem: Patients who attend the ED with AF are at high risk of hospital admission.

Approach: A nurse practitioner (NP) was added to the Heart Rhythm team to create a program to improve AF care after an ED visit. Telephone practice was one of the many processes created.

Outcomes: Findings revealed that 37 of 90 patients presented to the ED with AF prior to telephone contact and 7 of 90 patients did so post-telephone contact (P < .001).

Conclusion: Telephone practice led by an NP provides an opportunity to improve assessment and management of patient with AF and offers a promising cost-effective method to reduce ED visits in the AF patient population.

MeSH terms

  • Atrial Fibrillation / therapy*
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospitals
  • Humans
  • Male
  • Nurse Practitioners / standards*
  • Patient Readmission / statistics & numerical data
  • Retrospective Studies
  • Telemedicine*
  • Telephone