2.50
Hdl Handle:
http://hdl.handle.net/10755/156966
Category:
Abstract
Type:
Presentation
Title:
Impact of Cardiac Surgical Stepdown on Critical Care Readmissions
Author(s):
Cepero, Karen Ann
Author Details:
Karen Ann Cepero, RN,MS,MSN,CCRN,CEN, Washington Hospital Center, Washington, DC, USA, email: karen.cepero@medstar.net
Abstract:
PURPOSE: Despite initial recovery after cardiac surgery, with admission to a critical care unit and subsequent step-down, many patients remain at risk for associated deterioration and death. Readmission to critical care is associated with a significant increase in mortality and morbidity. The intent of the project was to evaluate if placing cardiac surgical step-down patients in one location would reduce the incidence of readmissions to the critical care. DESCRIPTION: Two in-patient units in a large tertiary teaching hospital were occupied with cardiac, thoracic, and vascular surgical patients. Variability in patient specialty and in caregivers assigned to patients was causing inconsistencies in how care was delivered. A multidisciplinary cardiac council composed of leadership, nurses, physicians, nurse practitioners, staff, and case management was developed to look at the nature of readmissions and plan for a service line approach populating the cardiac surgery patients in one location to improve continuity of care, patient satisfaction, and focus resource allocation to services that support patient care strategies. The council inspired a vision that was shared by all associates including plans for an official name change in the unit. The staff underwent competency training on advanced care of the cardiac surgical patient and established and revised clinical pathways including preparation of patient friendly pathways allowing the patients to measure their own daily outcomes. We measured cardiac surgical readmissions to critical care before and after cohorting patients in one location. EVALUATION/OUTCOMES:Cardiac surgical readmissons before cohorting in the step-down unit over a 1-year period ranged from 6.7% to 8.9 %. After 6 months of cohorting cardiac surgical patients, the readmission rate was reduced to 4%. This cardiac surgical step-down unit with the focus on a specific patient population created a framework for nurses that allows them to focus on the cardiac surgical population in a targeted specific care delivery model and helped to promote excellence in outcomes. Creating a service line allowed the department to work toward a shared vision, installing new standards and processes and closely monitoring progress toward their goals.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImpact of Cardiac Surgical Stepdown on Critical Care Readmissionsen_GB
dc.contributor.authorCepero, Karen Annen_GB
dc.author.detailsKaren Ann Cepero, RN,MS,MSN,CCRN,CEN, Washington Hospital Center, Washington, DC, USA, email: karen.cepero@medstar.neten_GB
dc.identifier.urihttp://hdl.handle.net/10755/156966-
dc.description.abstractPURPOSE: Despite initial recovery after cardiac surgery, with admission to a critical care unit and subsequent step-down, many patients remain at risk for associated deterioration and death. Readmission to critical care is associated with a significant increase in mortality and morbidity. The intent of the project was to evaluate if placing cardiac surgical step-down patients in one location would reduce the incidence of readmissions to the critical care. DESCRIPTION: Two in-patient units in a large tertiary teaching hospital were occupied with cardiac, thoracic, and vascular surgical patients. Variability in patient specialty and in caregivers assigned to patients was causing inconsistencies in how care was delivered. A multidisciplinary cardiac council composed of leadership, nurses, physicians, nurse practitioners, staff, and case management was developed to look at the nature of readmissions and plan for a service line approach populating the cardiac surgery patients in one location to improve continuity of care, patient satisfaction, and focus resource allocation to services that support patient care strategies. The council inspired a vision that was shared by all associates including plans for an official name change in the unit. The staff underwent competency training on advanced care of the cardiac surgical patient and established and revised clinical pathways including preparation of patient friendly pathways allowing the patients to measure their own daily outcomes. We measured cardiac surgical readmissions to critical care before and after cohorting patients in one location. EVALUATION/OUTCOMES:Cardiac surgical readmissons before cohorting in the step-down unit over a 1-year period ranged from 6.7% to 8.9 %. After 6 months of cohorting cardiac surgical patients, the readmission rate was reduced to 4%. This cardiac surgical step-down unit with the focus on a specific patient population created a framework for nurses that allows them to focus on the cardiac surgical population in a targeted specific care delivery model and helped to promote excellence in outcomes. Creating a service line allowed the department to work toward a shared vision, installing new standards and processes and closely monitoring progress toward their goals.en_GB
dc.date.available2011-10-26T19:18:06Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:18:06Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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