Cardiac Surgery Peer Recovery Support Program

In 2015, Cardiac Surgery service at the University of Rochester Medical Center surgically treated 33 patients with IE. Of these 33, 12 patients had a history of IV drug use prior to their admission. Five patients had recent IV drug use which is defined as use less than 30 days prior to admission. In 2016, Cardiac Surgery service surgically treated 41 patients with endocarditis. Of these 41, 20 patients had a history of recent IV drug use prior to their admission. Nine patients had recent IVDU. In 2017, IE admissions did decrease, 16 patients with IE were surgically treated. Of these, 6 patients had recent IVDU prior to admission (Figure 3) (P. Krause, personal communication, 12/20/2017). These numbers only represent the patients that had undergone surgical repair/replacement of their cardiac valves and thus do not include the patients that were admitted to the cardiac surgery service, medically managed, and then transferred or discharged to home.

The investigators do not have a total number of target subjects due to the variability of admissions with IE. The goal is to have at least 10 subjects enrolled and complete all follow ups.

• Inclusion Criteria:

All patients considered for this program must meet the following criteria:

• Must be at least 18 years of age and able to provide consent
• Must speak/read/understand English
• Currently hospitalized and physically located on 7-3600 unit
• Followed by or on the Cardiac Surgery service
• Have a diagnosis of Endocarditis associated with recent or remote intravenous drug use (IVDU)
• Alert and oriented to person, place, time, and events leading up to hospitalization
• Able to carry on a coherent conversation
• Clinical Opiate Withdrawal (COW) score of less than or equal to 5 with no adjunctive (opioids) medication use within past 24 hours a. If COW score is greater than five or adjunctive medications have been used within the previous 24 hours, the patient will be re-evaluate every 24 hours until score is less than or equal to five and no adjunctive medications used within the previous 24 hours
• Exclusion Criteria:

• Under the age of 18 years old
• Unable to speak/read/understand English
• Hospitalized but not on 7-3600
• Does not have a diagnosis of endocarditis associated with IVDU
• Not followed by or on the Cardiac Surgery service
• Not Alert or oriented or unable to carry on a coherent conversation
• COW score that is greater than five or adjunctive medications have been used within the previous 24 hours (see inclusion criteria)

Inclusion criteria

All patients considered for this program must meet the following criteria:

• Must be at least 18 years of age and able to provide consent
• Must speak/read/understand English
• Currently hospitalized and physically located on 7-3600 unit
• Followed by or on the Cardiac Surgery service
• Have a diagnosis of Endocarditis associated with recent or remote intravenous drug use (IVDU)
• Alert and oriented to person, place, time, and events leading up to hospitalization
• Able to carry on a coherent conversation
• Clinical Opiate Withdrawal (COW) score of less than or equal to 5 with no adjunctive (opioids) medication use within past 24 hours a. If COW score is greater than five or adjunctive medications have been used within the previous 24 hours, the patient will be re-evaluate every 24 hours until score is less than or equal to five and no adjunctive medications used within the previous 24 hours

Exclusion criteria

• Under the age of 18 years old
• Unable to speak/read/understand English
• Hospitalized but not on 7-3600
• Does not have a diagnosis of endocarditis associated with IVDU
• Not followed by or on the Cardiac Surgery service
• Not Alert or oriented or unable to carry on a coherent conversation
• COW score that is greater than five or adjunctive medications have been used within the previous 24 hours (see inclusion criteria)