ABSTRACT
Innovations in surgical and medical treatment continue to improve the outlook for children with complex congenital heart disease. Although mortality continues to decrease, disease-related morbidity is increasing as a large cohort of these patients is reaching young adulthood, pursuing careers, marrying, and in many cases having children of their own. Chronic recurrent dysrhythmias are a frequent cause of long-term morbidity in this population and result in frequent, unanticipated emergency room visits and hospitalizations. Although not usually life threatening, they can pose considerable challenges to the patients and the providers who care for them. This article provides an overview of the most common dysrhythmias encountered in this population, dysrhythmia substrates, and therapeutic options.
Subject(s)
Arrhythmias, Cardiac/diagnosis , Heart Defects, Congenital/nursing , Heart Defects, Congenital/surgery , Postoperative Complications/diagnosis , Arrhythmias, Cardiac/nursing , Arrhythmias, Cardiac/physiopathology , Child , Electrocardiography , Humans , Perioperative Nursing/methods , Postoperative Complications/nursing , Postoperative Complications/physiopathologyABSTRACT
A critical path defines the optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure. Critical paths are developed through collaborative efforts of physicians, nurses, pharmacists, and others to improve the quality and value of patient care. They are designed to minimize delays and resource utilization and to maximize quality of care. Critical paths have been shown to reduce variation in the care provided, facilitate expected outcomes, reduce delays, reduce length of stay, and improve cost-effectiveness. The approach and goals of critical paths are consistent with those of total quality management (TQM) and can be an important part of an organization's TQM process.
