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World J Clin Cases. Nov 26, 2023; 11(33): 7943-7950
Published online Nov 26, 2023. doi: 10.12998/wjcc.v11.i33.7943
Table 1 Approaches and outcomes of nursing for patients undergoing cardiac surgery
Item
Nursing approach
Nursing measures
Nursing outcomes
Preoperative nursingPredictive nursing[11]Guiding the patient to use Betadine mouthwash before surgeryPostoperative pneumonia risk reduced by approximately 50%
Individualized education[12,13]Providing individualized preoperative care for 30-90 min based on the patient's sources of anxietyPatients quickly adapt to the ICU environment, with a satisfaction rate of 94% given for preoperative education
Inspiratory muscle training[14]Instructing the patient to undergo respiratory muscle training for 5 dMarked improvement in postoperative respiratory muscle strength, reducing the incidence of complications and hospital stay
Orientation tour[15]One day before surgery, healthcare personnel visit the patient to explain the surgical process (15 min) and accompany them to visit an unattended operating room at night (10 min), the ICU (5 min), an operating room (10 min)Decreased levels of anxiety
Intraoperative nursingPDCA cycle intervention[16,17]Using the PDCA cycle management method, continuous quality improvement is implemented in the preparation phrase for cardiac surgery by the methods of identifying the causes, formulating countermeasures, eliminating potential risks, optimizing workflow, and so onReduces the variability and risks of operating room work to ensure smooth surgical procedures
Holistic care[18]Four 30- to 45-min sessions of nursing intentional presence were conducted for each patient individually in the intervention groupEffectively reduce depression, stress, and anxiety in surgical patients
Postoperative nursingComfort nursing intervention[19]Collecting demographic details, comfort behaviors, hemodynamic parameters, and other data and implementing comfort care interventionsMajorly improve indicators of postoperative pain, discomfort, respiration, and heart rate in pediatric patients
Cold compress nursing[20]Using cold compresses to alleviate pain caused by chest tube removal after cardiac surgeryCold compress during chest tube removal significantly reduces the severity of pain scores, but the effect is not significant after 15 min of removal
Slow, deep breathing relaxation exercises[21]Instructing 25 patients undergoing coronary artery bypass graft surgery to perform slow deep breathing relaxation exercises before chest tube removalPain levels are significantly reduced at 5 min and 15 min after extubation
Nursing interventions to prevent delirium in ICU[22-25]Nurse-led preventive nursing interventions targeting patients with visual and auditory impairments, sleep disorders, cognitive impairments, and mobility impairments, among other major risk factors for deliriumPrevents postoperative delirium, reduces its incidence, and shortens mechanical ventilation time and ICU stay
Pain nursing[27,28]Patients are provided with a 30-min continuous NLP technique and guided imagery relaxation technique using audio CDs to promote behavior formation. Additionally, 0.5% bupivacaine wound infiltration is administered within 12 h after surgery to alleviate painComfort levels markedly improve, reducing postoperative pain and enhancing patient comfort in patients undergoing cardiac surgery
Nurse-led transitional care model[29]Transitional care is provided for 9 wk after patient discharge, to facilitate their gradual adjustment, along with provision of necessary supportThe self-measurement system and quality of life scale scores both significantly improved, and readmission rates were significantly reduced
EGDTAn EGDT team is established to develop personalized, feasible, and progressive rehabilitation plans for patientsEGDT can shorten the duration of endotracheal intubation and ICU stay for patients, reduce the occurrence of complications, and enhance patient satisfaction
Early rehabilitation nursing[30]A rehabilitation nursing quality control group is created to develop and implement postoperative early progressive graded activity protocols and ensure quality control throughout the implementation processEarly rehabilitation nursing has enhanced nurses' awareness of early interventions and improved team collaboration efficiency, which can accelerate patient recovery and shorten hospital stay
Perioperative nursing interventionEnhanced recovery surgical nursing[31,32]A multimodal and interdisciplinary approach is implemented to optimize nursing care throughout the entire surgical process, including preoperative, intraoperative, and postoperative phasesReduce ICU and hospital stay, postoperative complications, and costs for patients undergoing cardiac surgery
Music intervention[37]Music interventions are utilized for patients during the surgical procedureSignificantly reduce postoperative anxiety and pain in patients undergoing cardiac surgery without any side effects
Zero-defect care model and psychological care[38]Nursing staff undergo specialized training on the theory of zero defects to enhance their professional competence. They also provide preoperative health education and psychological counseling for patientsSignificantly decrease surgical time, intraoperative bleeding, and hospital stay and improve sleep quality, mental well-being, and psychological condition