The purpose of the Parent Education Discharge Instruction (PEDI) program is to teach nurses how to effectively impart home care information to parents in order to improve cardiac surgery outcomes for children in resource constrained environments. The PEDI program consists of a computer-based discharge education training program for nurses, individualized and group teaching sessions for parents, and standardized parent educational resources designed for both literate and low-literacy parents. The PEDI program is designed to enable: 1) nurses to effectively convey knowledge and skills to parents (and other caregivers such as grandparents), and 2) parents to care for their children after discharge. Nurse and parent mastery of home care instructions are important precursors to optimal health and well-being of children with congenital heart disease (CHD) after palliation or corrective surgery.

This dissertation presents an evaluation of the PEDI program in two studies conducted in Southern India and findings are presented in three papers. The PEDI program was evaluated for feasibility at one location in Southern India and then, the effects of the PEDI program on nurse, parent, and child outcomes were examined at a different hospital in Southern India. The first paper, Pediatric Cardiac Surgery Parent Education Discharge Instruction (PEDI) Program: A Pilot Study, describes program development and critically appraises the PEDI program. The second paper, Parent Education Discharge Instruction Program for Care of Children at Home after Cardiac Surgery in Southern India, examines the PEDI program's effects on nurse and parent home care knowledge and the influence of knowledge on child outcomes (specifically surgical site infections, length of stay from cardiac procedure to discharge, and primary hospitalization and readmission costs). Finally, the third paper, An Analysis of Parent and Nurse Perceptions Associated with the Parent Education Discharge Instruction Program in Southern India, describes and compares nurses' and parents' perceptions before and after PEDI program implementation. The main findings of the two studies were that the PEDI structured nurse-led parent discharge program was feasible and perceived as useful by nurses and parents. In the second study, findings suggest that the program may improve at-home outcomes for children with CHD after cardiac surgery. The second study (third paper) findings also suggest that parent discharge teaching affects parent and nurse perceptions of parent uncertainty and readiness for discharge. Overall, the program shows promise, but further research is needed to examine direct relationships between nursing practice and clinical outcomes. Empowering nurses to perform parental discharge teaching by educating them on home care instructions and expanding their role to include autonomous teaching functions could have positive influences on child outcomes after cardiac surgery.

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