Hall 1975.
Methods | Study design: quasi random controlled trial based on terminal digit of accession number. Unit of allocation: Patient Unit of analysis: Patient Power calculation: Not done Concealment*: Unclear method of assignment was 'withheld from physicians' Follow‐up*: 94.6%. Blinded assessment*: Done for length of stay and discharge destination. Not done for functional status. Baseline*: Differences noted in functional independence in favour of intervention group. Reliable outcomes*: Done for length of stay and discharge destination. Not clear for functional status. Contamination*. Possible for long term follow up ‐ control patients readmitted to NL ‐ but not substantial (14 patients in total) Intention to treat analysis*: Done | |
Participants | Patients post acute coronary event (MI, heart failure rhythm disorder) assessed as being medically stable and having a remediable nursing need. Treatment 351 mean age 66.2, 39% Female mean 19.8 days post admission Control 188 mean age 67.0, 40% Female mean 20.1 days post admission 94.6% of patients followed up for main outcome (death within 18 months) |
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Interventions | Unit / setting: 2 x 40 bed units attached to acute general / tertiary care teaching hospital
Care management: Admission authorised by nurse manager . Care planned and managed by primary nurse.
Nursing Team: Described as all Registered Nurses. 1 RN per 8/10 patients during the day
MD team: No detail given ‐ the role of other professions is described as advisory
Education / preparation for staff:
Other: Extensive descriptions are given of changes in the philosophy and approach to nursing and attempts to make the unit more informal and inviting (open visiting) Control: Usual care in medically managed acute units |
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Outcomes | Lenght of stay Mortality to 18 months Independence Readmission Hospital charges Satisfaction | |
Notes | Quality score 2/7 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment? | Unclear risk | D ‐ Not used |