effect of early activity on patients outcome after open heart surgery

The postoperative phase is the most critical period for open heart surgery during which many serious and fatal complications can occur. Early physical activity can prevent such complications. The role of the critical care nurse is crucial in this concern. The present study aimed to examine the effect of early activity on patient's outcome after open heart surgery. Design: A comparative experimental design was applied. This study was conducted in the Intensive Care Unit [ICU] of Open Heart Surgery at Mansoura Main University Hospital. Sample: Fourty adults patients of both sexes undergoing open heart surgery using cardiopulmonary bypass and showing hemodynamic stability. An activity regime was applied to 20 patients who underwent such surgery. The results were compared to a matching control group. Early activity included positioning [supine, left and right sides], early ambulation [dangling, standing near the bed, chair sitting and walking] and chest physiotherapy procedures [coughing, breathing exercises, percussion, vibration and incentive spirometry]. Comparing the obtained data revealed a better outcome among the early activity group. This was manifested by better recovery in the respiratory features especially crackles and grade II dyspnea and lung functions [FVC, FEV1 and MVV]. In addition, lower postoperative rates of dysrhythmia and atelectasis were found among the early activity group. Moreover, early activity reduced significantly the length of stay in the ICU. However, no differences could be detected between the two groups concerning oxygenation and hemodynamic parameters and renal indicators. Combination of early activity and chest physiotherapy ameliorates the outcome of patients after open heart surgery. Performing early activity to such patients is recommended

Patient dependency scoring as indices for determining staffing adequacy

Patient-dependency scoring system was developed based on assessment of patients' condition, in the intensive care unit within the casuality department. Criteria for classification were identified. Patients were classified into three categories: high, medium and low-dependency care groups. Not all the seriously ill patients require the same hours of nursing care. The average number of hours required per patient per shift varied from low to high dependency-care groups namely from one and half up to six hours. It is proposed to use the developed system, as cost-effective, in the ICUC for the projection of staffing requirements