CNS facilitation of a cardiac surgery clinical pathway program.

J. B. Jacavone, Richard Daniels, I. Tyner

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

In this collaborative project, the Clinical Nurse Specialist (CNS) worked with various members of the healthcare team using a clinical pathway group work process to implement changes in the nursing, medical, and respiratory care of cardiac surgery patients. The patient population (N = 598) comprised cardiac surgery patients undergoing coronary artery bypass graft, mitral valve replacement, or aortic valve replacement. The practice changes implemented were earlier extubation, earlier ambulation, the administration of fentanyl and propofol, and the administration of gastrointestinal (GI) prophylactic medications. The overall outcomes were decreased incidence of pneumonia, earlier increase in level of consciousness, improved ambulation abilities, and improved nausea levels. Pneumonia decreased significantly, from 2.49% to 1.67% (p = 0.05). For patients who met early extubation criteria, mean time on the ventilator decreased from 17 hours to 8 hours, and length of stay decreased from 8 days to 7 days in a subgroup of patients (diagnosis-related group (DRG) 105). The overall annual charge savings was approximately $201,000. These results add to the belief that CNS-guided patient care in collaboration with the healthcare team has positive benefits.

Original languageEnglish (US)
Pages (from-to)126-132
Number of pages7
JournalClinical nurse specialist CNS
Volume13
Issue number3
StatePublished - May 1999
Externally publishedYes

Fingerprint

Nurse Clinicians
Critical Pathways
Thoracic Surgery
Patient Care Team
Pneumonia
Early Ambulation
Aptitude
Group Processes
Diagnosis-Related Groups
Fentanyl
Propofol
Mechanical Ventilators
Consciousness
Aortic Valve
Mitral Valve
Coronary Artery Bypass
Nausea
Walking
Length of Stay
Patient Care

ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Assessment and Diagnosis
  • Leadership and Management
  • LPN and LVN

Cite this

CNS facilitation of a cardiac surgery clinical pathway program. / Jacavone, J. B.; Daniels, Richard; Tyner, I.

In: Clinical nurse specialist CNS, Vol. 13, No. 3, 05.1999, p. 126-132.

Research output: Contribution to journalArticle

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