CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
274
AFRICA
10 centres published between 1975 and 2010 constituted the evidence
base for this review. Most interventions occurred within the first few
months of the child’s birth and/or diagnosis. Most were conducted in
the hospital or clinic. One study involved an interactive website and
another evaluated a video-conferencing intervention. Seven interven-
tions involved a combination of parent education and psychological
support. Four studies concerned home-based management of anti-
coagulation therapy. Regarding study design, seven studies had a
comparison or control group, and two studies involved randomisation.
Five studies included mothers only, three included mothers and fathers,
and four studies did not specify numbers of mothers and fathers.
Conclusion
: Interventions beyond the time of diagnosis are needed
as parents face further transitions with their child, such as additional
surgeries and entering preschool. Timely parental intervention is
required to optimise child and family outcomes. Settings other than
hospitals and clinics are needed. Innovative technology to provide
interventions at home and interventions for both mothers and fathers
are needed.
1073: THE EVALUATION OF A SHORT-TERM EDUCATION-
AL STRATEGY: CAN THIS IMPROVE KNOWLEDGE AND
CONFIDENCE AMONG PARTICIPANTS IN IRAQ?
Stacey Marr, Frank Molloy, Caroline Lonsdale
International Children’s Heart Foundation, Memphis, TN, USA
Background:
Congenital heart disease in the developing world creates
a significant burden of disease and to date the development of sustain-
able health systems that will treat and manage these conditions has not
been a global priority. The International Children’s Heart Foundation
(ICHF) is a charitable organisation that collaborates with local teams in
the developing world to build paediatric cardiac surgical programmes.
This project aims to evaluate the effectiveness of a two-week educa-
tional intervention in a paediatric cardiac intensive care unit in Iraq
during a collaborative surgical visit. The research question is: Does
a two-week, mixed-method educational programme have an effect on
the knowledge and self-reported confidence level of participants in a
paediatric cardiac intensive care unit in Iraq? There is little consensus
on competence when applied to clinical practice, however,
confidence
and knowledge are attributes that have been closely linked with the
ability to perform and have been shown to guide future behaviours.
Methods:
Participants on the course will be asked to complete a pre- and
post-course questionnaire, the ICU Education Evaluation Questionnaire
(IEEQ), which has been designed and tested to measure knowledge and
self-reported confidence levels before and after the educational inter-
vention. The project will seek to establish correlation links between the
identified variables, namely, the education programme, knowledge and
self-reported confidence levels of participants.
Results:
Data were collected from 8 to 22 September 2012. It is
anticipated that there will be a difference in both confidence and
knowledge among the group.
Conclusions:
The ability of ICHF to tailor future educational inter-
ventions toward the requirements of the local team will improve the
uptake of education and improve the competence of the whole team.
1150: PAEDIATRIC NURSE PRACTITIONER-MANAGED
CARDIOLOGY CLINICS: PATIENT SATISFACTION AND
APPOINTMENT ACCESS
Julianne Evangelista
1
, Jean Anne Connor
1
, Christine Pintz
2
, Teresa
Saia
1
, Cheryl O’Connell
1
, David Fulton
1
, Patricia Hickey
1
1
Boston Children’s Hospital, USA
2
The George Washington University, USA
Background:
Appointment waiting times exceeded 40 days in the
out-patient cardiology department at a children’s hospital. To address
the gap in available appointments, paediatric nurse practitioner-
managed cardiology clinics were implemented.
Methods:
A sample of 128 patients who presented concurrently in
physician or paediatric nurse practitioner-managed cardiology clin-
ics was recruited for participation. The hospital’s ambulatory patient
satisfaction survey was used to measure level of patient satisfaction
with healthcare. Survey responses were evaluated using Fisher’s
exact test. Appointment waiting times were compared pre- and post-
implementation of paediatric nurse practitioner-managed clinics.
Results:
Sixty-five physician and 63 paediatric nurse practitioner
families completed the satisfaction survey. There was no statistically
significant difference in patient satisfaction between clinic types.
Appointment waiting time decreased from 46 to 43 days, which was
not statistically significant, but was clinically important. Paediatric
nurse practitioner clinics evaluated a statistically higher percentage
of urgent appointments compared to physician clinics. With the addi-
tion of several weekly nurse practitioner-managed cardiology clinics,
current waiting times in the out-patient cardiology department are
now at less than one week.
Conclusions:
Paediatric nurse practitioner-managed cardiology clin-
ics are a strategic solution for improving patient access and facilitat-
ing high-quality patient care while earning high levels of patient
satisfaction. This healthcare delivery model illustrates successful
expanded utilisation of advanced practice nurses.
1180: PERCUTANEOUS PULMONARY VALVE IMPLAN-
TATION: EXPERIENCES OF THE PATIENT AND THEIR
CLOSE RELATIVES
Brith Andresen, Harald Lindberg, Marit Helen Andersen, Gaute
Døhlen, Erik Fosse
Oslo University Hospital, Norway
Background:
Percutaneous pulmonary valve implantation (PPVI)
reduces the number of open-chest procedures during childhood and
adolescence. As operative survival has improved, the focus of PPVI
has turned to quality-of-life aspects and patient-assessed experience
of treatment. This study evaluated the physical and psychosocial
aspects of daily life of patients and relatives undergoing PPVI.
Methods:
Ten consecutive patients were included in the prospective,
qualitative study from April 2007 to June 2011. Patients and close
relatives participated in individual in-depth interviews one day before
and three months after PPVI. All patients and close relatives had
previously experienced cardiac surgery and subsequent paediatric
cardiac intensive care.
Results:
This less-invasive procedure resulted in an earlier return to
daily life and activities compared with previous experiences (median
2.4 days in hospital), with patients resuming their social role and
function. Close relatives stated that both the short hospital stay and
improved function of their child was of benefit to the child, the family
and society.
Conclusion:
This study shows that striving for normality of life
is a main goal for both patients and their relatives. In facilitating
patients to achieve optimal social function in school, at home and
with peers, PPVI appears to offer a favourable approach, due to the
minimal interference in daily life. Furthermore, this study allows for
the evaluation of our health system from both a patient and a family
perspective.
1268: INCREASED KNOWLEDGE REQUIRED IN ADULTS
WITH RHEUMATIC HEART DISEASE: THE CAPE TOWN
EXPERIENCE
Alexia Joachim
1
, Liesl Zuhlke
1,2
, Mark Engel
1
, Rezeen Daniels
1
,
Blanche Cupido
1
, Nonkuleko Koyana
1
, Ganesan Karthikeyan
3
, Salim
Yusuf
4
, Koon Teo
4
, Bongani M Mayosi
1
1
Department of Medicine, Groote Schuur Hospital, University of
Cape Town, South Africa
2
Division of Paediatric Cardiology, Department of Paediatrics and
Child Health, Red CWMCH, UCT, South Africa
3
Department of Cardiology, All India Institute of Medical Science,
New Dehli, India
4
Population Health Research Institute, Mcmaster University,
Hamilton, Ontario, Canada
