A Focus on Congestive Heart Failure-Related Patient Education After Open Heart Surgery: A Quality Improvement Project.

IF 0.2 Q4 NURSING Journal of Doctoral Nursing Practice Pub Date : 2021-01-19 DOI:10.1891/JDNP-D-20-00007
Preston Briggs
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Abstract

Background: After open heart surgery patients often develop symptoms associated with congestive heart failure (CHF), or fluid volume overload. To prevent heart failure-related symptoms in the postoperative period patients must be educated on heart failure self-care.

Objective: To decrease the percentage of postoperative open heart surgical patients with CHF-related questions and concerns from 44% to 30% by March 2020.

Methods: A cardiac surgery educational booklet and an educational electronic health record template were identified to guide a CHF educational pathway. Intensive care staff nurses provided patient education after surgery. PDSA cycles were performed in succession to roll out the quality improvement (QI) initiative.

Results: Of patients experiencing postoperative issues, 44% of patients developed symptoms or concerns related to heart failure. Upon implementation of the CHF-focused pathway 15% of patients were exhibiting symptoms or concerns related to CHF, out of all patients with postoperative issues.

Conclusions: CHF, and fluid volume overload continues to be a difficult pathology requiring close management and follow up. After open heart surgery, providing concise, CHF-focused education results in reduced CHF-related patient concerns after discharge.

Implications for nursing: By providing a disease-focused patient education nurses can reduce the complications that patients develop after an inpatient hospital.

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关注开胸手术后充血性心力衰竭相关的患者教育:质量改进项目。
背景:开放性心脏手术后,患者通常会出现充血性心力衰竭(CHF)或体液容量超负荷的相关症状。为防止术后出现心衰相关症状,必须对患者进行心衰自我护理教育:目标:到 2020 年 3 月,将术后有 CHF 相关问题和顾虑的开胸手术患者比例从 44% 降至 30%:方法:确定了心脏手术教育手册和教育电子健康记录模板,以指导 CHF 教育路径。重症监护护士在手术后对患者进行教育。连续执行 PDSA 循环,推出质量改进(QI)举措:结果:在术后出现问题的患者中,44% 的患者出现了与心衰相关的症状或问题。实施以心力衰竭为重点的路径后,在所有术后问题患者中,15% 的患者出现了与心力衰竭相关的症状或问题:结论:心力衰竭和体液容量超负荷仍然是一种困难的病理现象,需要严密的管理和随访。结论:CHF 和体液容量超负荷仍然是需要密切管理和随访的疑难病症。在开放式心脏手术后,提供简明扼要、以 CHF 为重点的教育可减少出院后患者对 CHF 相关问题的担忧:对护理工作的启示:通过提供以疾病为重点的患者教育,护士可以减少患者在住院后出现的并发症。
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45
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