title: Technology-enhanced practice for patients with chronic cardiac disease: home implementation and evaluation.
abstract: OBJECTIVE
  This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home-care nursing model, referred to as technology-enhanced practice (TEP).
  
  
  METHODS
  Nurses using TEP augmented the usual care with a web-based resource (HeartCareII) that provided patients with self-management information, self-monitoring tools, and messaging services.
  
  
  RESULTS
  Patients exposed to TEP demonstrated better quality of life and self-management of chronic heart disease during the first 4 weeks, and were no more likely than patients in usual care to make unplanned visits to a clinician or hospital. Both groups demonstrated the same long-term symptom management and achievements in health status.
  
  
  CONCLUSIONS
  This project provides new evidence that the purposeful creation of patient-tailored web resources within a hospital portal is possible; that nurses have difficulty with modifying their practice routines, even with a highly-tailored web resource; and that the benefits of this intervention are more discernable in the early postdischarge stages of care.
authors.affiliation: University of Wisconsin Madison School of Nursing, Madison, Wisconsin 53792, USA. pbrennan@engr.wisc.edu
authors.forename: Patricia Flatley
authors.initials: PF
authors.lastname: Brennan
authors.forename: Gail R
authors.initials: GR
authors.lastname: Casper
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Burke
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Johnson
authors.forename: Roger
authors.initials: R
authors.lastname: Brown
authors.forename: Rupa S
authors.initials: RS
authors.lastname: Valdez
authors.forename: Marge
authors.initials: M
authors.lastname: Sebern
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Perez
authors.forename: Billie
authors.initials: B
authors.lastname: Sturgeon
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003194:Computer-Assisted Instruction; D003205:Computing Methodologies; D018961:Educational Technology / Q000295:instrumentation*; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology / Q000628:therapy; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D010351:Patient Discharge; D010353:Patient Education as Topic; D010358:Patient Participation / Q000523:psychology; D011637:Public Health Nursing / Q000458:organization & administration*; D011788:Quality of Life / Q000523:psychology; D012648:Self Care