ABSTRACT
Postoperative nursing management of cardiac surgery patients is considered part of perianesthesia nursing core curriculum by ASPAN. In many hospitals, however, these patients bypass the PACU and are admitted directly to the ICU. For that reason, perianesthesia nurses who do not have cardiothoracic surgical ICU experience need information related to the immediate postoperative routine and nursing care regimen of cardiac surgery patients. Bleeding, cardiac tamponade, low cardiac output syndrome, and dysrhythmias are postoperative complications that are discussed. A brief overview of postoperative nursing management and several "nursing pearls of wisdom" are also presented.
Subject(s)
Cardiac Surgical Procedures/nursing , Postanesthesia Nursing/methods , Postoperative Complications/nursing , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/nursing , Cardiac Tamponade/etiology , Cardiac Tamponade/nursing , Hemodynamics , Humans , Postoperative Complications/etiology , Postoperative Complications/physiopathology , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/nursing , Shock, Cardiogenic/etiology , Shock, Cardiogenic/nursingABSTRACT
Health care practitioners at all levels within an organization have a professional responsibility to deliver quality patient care. The overall systems operation, as well as customer outcomes, can be enhanced by using redesign and process improvement strategies. This article highlights the implementation of these change strategies as a part of process improvement efforts in the Outpatient Surgery Care Unit (OSCU). OSCU work process redesign was one in a series of 8 redesign efforts in the department of Surgical Services. A summary of the redesign process and its corresponding educational program is provided. Tools used to enhance efficiency and cost savings are also included.
Subject(s)
Hospital Restructuring/organization & administration , Outcome and Process Assessment, Health Care/organization & administration , Outpatient Clinics, Hospital/organization & administration , Surgicenters/organization & administration , Total Quality Management/organization & administration , Work Simplification , Cost Savings , Education, Nursing, Continuing/organization & administration , Efficiency, Organizational , Health Services Research , Humans , Inservice Training/organization & administration , Michigan , Models, Organizational , Nursing Process , Nursing Staff, Hospital/education , Postanesthesia Nursing/education , Postanesthesia Nursing/organization & administration , Program Development , Program Evaluation , Trauma CentersABSTRACT
Laryngospasm is a potential serious complication of intubation. Pulmonary edema can develop after laryngospasm and can affect any patient who has been intubated. Postlaryngospasm pulmonary edema is potentially life threatening and can result in reintubation, mechanical ventilation, admission to an intensive care unit, and a prolonged hospitalization for the patient. Perioperative nurses play a significant role in the prompt detection, diagnosis, and treatment of this syndrome.
Subject(s)
Intubation, Intratracheal/adverse effects , Laryngismus/complications , Perioperative Nursing , Pulmonary Edema/etiology , Pulmonary Edema/nursing , Adult , Airway Obstruction/complications , Humans , Laryngismus/etiology , Laryngismus/prevention & control , Laryngismus/therapy , Male , Nursing Diagnosis , Pulmonary Edema/diagnosis , Pulmonary Edema/pathologyABSTRACT
Despite certification and graduate education, clinical nurse specialists are denied prescriptive authority in many states. Restrictions on their scope of practice and prescriptive authority are barriers to potential contributions to the health care delivery system. The article describes the experience of the New Mexico Council of Clinical Nurse Specialists in the process of obtaining prescriptive authority. It discusses council formation, lobbying activities, the legislative process, and ways to become politically involved. Clinical nurse specialists are encouraged to become politically active and work through their state nurses association to change restrictive policies.
