Effect of Implementation Decompensated Cirrhosis Discharge Bundle on Minimizing Readmission Rate within 30 Days

Document Type : Original Article

Authors

1 Nursing Specialist at Alrajhy Liver Hospital, Assiut University, Egypt.

2 Professor of Tropical Medicine and Gastroenterology, Faculty of Medicine ,Assiut University, Assiut, Egypt

3 Assistant Professor of Critical Care and Emergency Nursing, Faculty of Nursing, Assiut University, Egypt

4 Professor of Critical Care and Emergency Nursing, Faculty of Nursing, Assiut University, Egypt.

Abstract

Background: The discharge care bundle was being developed to review the management of cirrhotic complications at discharge adopted from the European Association for the Study of the Liver and should be started at least 48 hours prior to discharge but can be done earlier. Aim of the study: To evaluate the effect of implementing the Decompensated Cirrhosis Discharge Bundle on minimizing readmission rate within 30 days. Research design: Quasi experimental design was utilized in the study. Sitting: This study was conducted in the gastroenterology intensive care unit at Alrajhy Liver Hospital, Assiut University. The sample needed for the study was estimated to be 180 patients. 90 in each group. Three tools were utilized for data collection: Tool I patient assessment sheet, Tool II Decompensated Cirrhosis Discharge Bundle, and Tool III Patient outcomes tool. Results: The present study showed that only 10.9% of patients from the study group readmitted within 30 days, compared to 29% for the control group after application of Decompensated Cirrhosis Discharge Bundle, and the main reason for readmission was hepatic encephalopathy for the study and control groups (37.50%, 56.20%), respectively. Conclusion: The implementation of Decompensated Cirrhosis Discharge Bundle was successful in reducing the number of patients readmitted. Recommendations: The iimplementation of Decompensated Cirrhosis Discharge Bundle will be used to guide junior doctors and nurses in the management of gastrointestinal intensive care unit patients.

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