Effect of Early Patient Transfer to Floor after Transcatheter Aortic Valve Replacement Surgery (TAVR)
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Problem under investigation: Transcatheter aortic valve replacement (TAVR) is a surgery for aortic stenosis in lieu of open-heart surgery. Early patient transfer to the step-down floor is a new policy at an urban hospital. Outcomes of this policy have not been evaluated. Objective: Evaluate effectiveness of new policy in decreasing length of hospital stay (LOS). Background literature: Literature is inconclusive regarding appropriate time to transfer patient. Theoretical Framework: A Conceptual Model of Nursing and Health Policy provides guidelines for policy analysis and program evaluation. This study focused on the first level as this program evaluation helped in determining the effectiveness of the new policy on decreasing patient LOS and the outcomes of those involved in the procedure. Project Methods: Quasi-experimental retrospective chart review. Data analysis included t-test comparing LOS pre and post-policy and analysis of covariance (ANCOVA) to control for age and number of comorbidities. A p-value of <0.05 was statistically significant. Results: The mean for pre-policy group was 5.05 days with an SEM of ± 0.82. Mean for postpolicy group was 3.05 with an SEM of ± 0.68, showing a significant difference between these values (p = 0.0478). The comparison of the corrected means utilizing ANCOVA to control for the variables indicated a significant difference (p = 0.029, F= 3.359, df=3). Significance: Early patient transfer to the floor after a TAVR results in a decreased LOS. Limitations of this study include small sample size. Implications: The findings of this study show the potential for future research and the positive effect of early transfer to the floor after TAVR on patient LOS.