Strict adherence to bundled practices for preventing ventilator-associated pneumonia, enhanced accountability for initiating protocols, use of a feedback system, and interdisciplinary collaboration improved patients' outcomes and produced marked savings in costs.

To study the influence of psychosocial resources on psychological recovery after heart transplantation, 28 patients were surveyed during their hospitalization after transplant surgery and 6 months posttransplantation. Scales from the Coping With Serious Illness Battery were used to measure psychosocial resources (social support and personal control) and psychological and functional outcomes. Psychosocial resources assessed during hospitalization were associated with recovery outcomes at 6 months posttransplantation. Personal control was positively correlated with optimism, well-being, and satisfaction with life (r = .41 to .49) and negatively correlated with anger (r = -.57) and depression (r = -.52). Social support network helpfulness and attachment with others were correlated with psychological outcomes (r = .41 to .59) and functional outcome (r = .42 to .47). Efforts directed toward enhancing perceptions of personal control, social support network helpfulness, and attachment may be useful for promoting psychosocial recovery.

The purpose of this study was to evaluate the psychosocial impact of heart transplantation on spouses and compare the adjustment of spouses and their partners. Data were collected from 51 couples prior to transplant and 12 months posttransplant. The Psychosocial Adjustment to Illness Scale (PAIS) was used to measure adjustment in seven domains. Prior to the transplant, spouses experienced profound psychosocial distress related to their partner's illness. From pretransplant to posttransplant, PAIS total score decreased (lower scores indicate better adjustment) for spouses (M = 42, SD = 16, vs. M = 26, SD = 13). Spouses showed improvement in all domains. Posttransplant, patients' and spouses' PAIS total scores (overall adjustment) were not significantly different. Spouses reported more psychological distress than patients; patients reported more problems than spouses in vocational and domestic function. Study findings highlight the importance of sensitivity in the clinical setting to the distinct psychosocial needs of spouses.

Heart failure (HF) is a costly chronic disease that affects 5.7 million people in the United States. Home healthcare agencies are implementing initiatives to reduce hospitalizations and manage HF patients at home. In this study, telemonitoring improved patients' perception of their quality of life and assisted them to sustain critical self-care behaviors. Patients who were monitored had fewer hospitalizations but telemonitoring was not statistically significant in lowering hospitalizations.