Nurse Navigator Program for High-Risk Hospital Patients

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Decreased cognitive capacity

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

300 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to examine if educational intervention in high risk patients can lead to decreased hospital readmissions when compared to patients who are not in the intervention program. Additionally, to determine patient satisfaction with the educational program.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the Nurse Navigator Program treatment?

Research shows that nurse navigators can improve patient care by coordinating care and reducing hospitalizations. For example, a program in Queensland, Australia, evaluated hospital outcomes and found that nurse navigators can potentially reduce healthcare resource use. Additionally, a study showed a 50% reduction in hospitalizations for patients with chronic diseases when nurse navigators were involved. ^{1 2 3 4 5}

Is the Nurse Navigator Program safe for high-risk hospital patients?

Nurses play a crucial role in preventing adverse events (unintended harm) in hospitals, including medication errors and respiratory issues, which helps ensure patient safety. Programs involving nurses, like the Nurse Navigator Program, are generally focused on improving safety and reducing risks for patients. ^{6 7 8 9 10}

How is the Nurse Navigator Program unique compared to other treatments for high-risk hospital patients?

The Nurse Navigator Program is unique because it focuses on coordinating patient care and improving care quality through personalized support, which can potentially reduce hospitalizations and healthcare resource use. Unlike traditional treatments that may focus solely on medical interventions, this program emphasizes the role of nurse navigators in guiding patients through the healthcare system, especially those with multiple chronic conditions. ^{3 11 12 13 14}

Research Team

George Pujalte, MD

Principal Investigator

Mayo Clinic

Eligibility Criteria

This trial is for patients needing hip or knee replacement surgery who also have heart failure, COPD, require dialysis, abuse alcohol, or have a low BMI. It's not open to those with reduced ability to consent due to cognitive issues.

Inclusion Criteria

I need a hip or knee replacement and have heart issues, lung problems, need dialysis, have alcohol abuse history, or low BMI.

Exclusion Criteria

I am unable to understand and agree to the study on my own.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Patients with chronic conditions are contacted by a pre-operative nurse and then followed up by nurse navigator study team members

8 weeks

Initial contact and follow-up contacts at intervals

Follow-up

Participants are monitored for hospital readmissions and patient satisfaction with the educational program

4 weeks

Treatment Details

Interventions

• Nurse Navigator Program

Trial Overview The study tests if a Nurse Navigator Program can reduce hospital readmissions and improve patient satisfaction compared to usual care in high-risk surgical patients.

Participant Groups

Group I: Nurse Navigator Experimental Treatment 1 Intervention

Patients with chronic conditions slated for surgery contacted once by pre-operative nurse to discuss surgery, then contacted at intervals by nurse navigator study team members

Group II: Usual Practice Active Control 1 Intervention

Patients with chronic conditions slated for surgery contacted once by pre-operative nurse to discuss surgery

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

Findings from Research

A systematic review of seven studies highlights the effectiveness of oncology nurse practitioner navigators in improving timely care and enhancing patient and staff satisfaction.

The review emphasizes the importance of well-defined metrics for evaluating navigation programs, aligning with expert consensus recommendations, while also calling for more rigorous research tools in this field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review of oncology nurse practitioner navigation metrics. Johnson, F.[2022]

The review analyzed 18 primary nursing research studies and found that oncology nurse navigators positively impact measurable patient outcomes, including faster diagnosis and treatment, improved mood states, and higher patient satisfaction.

As the role of nurse navigators expands globally, it is crucial for nurses to embrace these opportunities to enhance patient care and evaluate the implications for their education and practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oncology nurse navigator. Case, MA.[2022]

A new tool for clinicians in inpatient oncology units has been developed to prevent adverse events and enhance patient safety, focusing specifically on cancer patients.

The tool includes a catalog of adverse events and a risk map, which helps healthcare providers implement best practices in their daily activities to improve clinical safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving patient safety in the inpatient setting through risk assessment and mitigation. Reche Navarro, MN.[2016]

Oncology nurse navigation programs significantly reduced the time from the first provider visit to the start of therapy for patients with hematologic malignancies, improving access to care.

Patient and provider satisfaction scores were high regarding the navigation program, although it did not lead to an increase in clinical trial enrollment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oncology Nurse Navigation: Development and Implementation of a Program at a Comprehensive Cancer Center . Gordils-Perez, J., Schneider, SM., Gabel, M., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Systematic review of oncology nurse practitioner navigation metrics. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Oncology nurse navigator. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Do nurse navigators bring about fewer patient hospitalisations? [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Our Nursing Profession at a Crossroads: Time to Chart a Course for the Future. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Implementing a Nurse Discharge Navigator: Reducing 30-Day Readmissions for Heart Failure and Sepsis Populations. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Understanding and preventing adverse drug events. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Improving patient safety in the inpatient setting through risk assessment and mitigation. [2016]

8. France pubmed.ncbi.nlm.nih.gov

[The correct usage of medicines, a safety concept]. [2016]

9. Brazil pubmed.ncbi.nlm.nih.gov

Role of perioperative nursing in anesthesia: a national overview. [2023]

10. England pubmed.ncbi.nlm.nih.gov

The role of nurses in preventing adverse events related to respiratory dysfunction: literature review. [2016]

11. United States pubmed.ncbi.nlm.nih.gov

Intervention Reduces Racial Disparity in Care of Lung Cancer Patients. [2022]

12. Canada pubmed.ncbi.nlm.nih.gov

[Montérégie Comprehensive Cancer Care Centre: integrating nurse navigators in Montérégie's oncology teams: one aspect of implementing the Cancer Control Program--Part 1]. [2019]

13. United States pubmed.ncbi.nlm.nih.gov

Examining the hurdles in defining the practice of Nurse Navigators. [2021]

14. United States pubmed.ncbi.nlm.nih.gov

Oncology Nurse Navigation: Development and Implementation of a Program at a Comprehensive Cancer Center . [2018]