2.50
Hdl Handle:
http://hdl.handle.net/10755/164076
Category:
Abstract
Type:
Presentation
Title:
Improving care for patients who develop atrial fibrillation after cardiac surgery
Author(s):
Dimick, Melissa
Author Details:
Melissa Dimick, MS, RN, CCRN, St. John Medical Center, Tulsa, Oklahoma, USA, email: nacnsorg@nacns.org
Abstract:
PURPOSE/OBJECTIVES: The purpose of this quality improvement project was to use evidence-based strategies to standardize treatment for patients who develop atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. SIGNIFICANCE: Atrial fibrillation (AF) is the most common complication following CABG surgery and can be associated with complications that increase hospital length of stay (LOS), along with increased health care costs. This improvement project focused on pharmacologic, as well as, non-pharmacologic therapies to treat new onset AF and restore sinus rhythm within twenty-four hours of recognition. BACKGROUND/RATIONALE: A retrospective review was conducted on post-operative CABG patients who developed AF in 2007. The data revealed gaps in practice including failure to recognize and report AF to the physician, along with inconsistent treatment by the practitioner. Consequently, patients had increased complications and longer hospitalizations. After implementation of an AF protocol/order set, a chart review is planned to monitor the new process. DESCRIPTION: Data from the retrospective review was presented to the appropriate stakeholders. A multidisciplinary committee was created that reviewed evidence-based treatment strategies for post-CABG AF. They developed a protocol and order set which focused on accurate identification of AF, immediate pharmacologic treatment with amiodarone, early electrical cardioversion, and appropriate use of anticoagulation. Nurses were educated on the use of the protocol/orders, along with the results of the chart review, significance of AF, and projected outcomes. Cardiologists and surgeons were also provided education during their monthly section meetings. OUTCOME: The goal is to use a standardized treatment approach AF using amiodarone coupled with early cardioversion. This plan is predicted to restore sinus rhythm within 24 hours and decrease hospital length of stay by one day. INTERPRETATION/CONCLUSION: After implementation of a post-CABG AF protocol/order set, the patient will experience safe and timely passage through the healthcare facility. The CNS student not only focused on patient-centered outcomes, but also advanced the practice of nursing by empowering the nurse to solve problems at the point of care. The organization benefits from decreased health care costs. IMPLICATIONS FOR PRACTICE: A best practice approach to post-CABG AF management provides predictable patient-centered outcomes. It also decreases complication risk for the patient and reduces hospital length of stay.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2010
Conference Name:
CNS as Interal Consultant: Influencing Local to Global Systems
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Portland, Oregon, USA
Description:
Conference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, 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_US
dc.typePresentationen_GB
dc.titleImproving care for patients who develop atrial fibrillation after cardiac surgeryen_GB
dc.contributor.authorDimick, Melissaen_US
dc.author.detailsMelissa Dimick, MS, RN, CCRN, St. John Medical Center, Tulsa, Oklahoma, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164076-
dc.description.abstractPURPOSE/OBJECTIVES: The purpose of this quality improvement project was to use evidence-based strategies to standardize treatment for patients who develop atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. SIGNIFICANCE: Atrial fibrillation (AF) is the most common complication following CABG surgery and can be associated with complications that increase hospital length of stay (LOS), along with increased health care costs. This improvement project focused on pharmacologic, as well as, non-pharmacologic therapies to treat new onset AF and restore sinus rhythm within twenty-four hours of recognition. BACKGROUND/RATIONALE: A retrospective review was conducted on post-operative CABG patients who developed AF in 2007. The data revealed gaps in practice including failure to recognize and report AF to the physician, along with inconsistent treatment by the practitioner. Consequently, patients had increased complications and longer hospitalizations. After implementation of an AF protocol/order set, a chart review is planned to monitor the new process. DESCRIPTION: Data from the retrospective review was presented to the appropriate stakeholders. A multidisciplinary committee was created that reviewed evidence-based treatment strategies for post-CABG AF. They developed a protocol and order set which focused on accurate identification of AF, immediate pharmacologic treatment with amiodarone, early electrical cardioversion, and appropriate use of anticoagulation. Nurses were educated on the use of the protocol/orders, along with the results of the chart review, significance of AF, and projected outcomes. Cardiologists and surgeons were also provided education during their monthly section meetings. OUTCOME: The goal is to use a standardized treatment approach AF using amiodarone coupled with early cardioversion. This plan is predicted to restore sinus rhythm within 24 hours and decrease hospital length of stay by one day. INTERPRETATION/CONCLUSION: After implementation of a post-CABG AF protocol/order set, the patient will experience safe and timely passage through the healthcare facility. The CNS student not only focused on patient-centered outcomes, but also advanced the practice of nursing by empowering the nurse to solve problems at the point of care. The organization benefits from decreased health care costs. IMPLICATIONS FOR PRACTICE: A best practice approach to post-CABG AF management provides predictable patient-centered outcomes. It also decreases complication risk for the patient and reduces hospital length of stay.en_GB
dc.date.available2011-10-27T11:41:35Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:41:35Z-
dc.conference.date2010en_US
dc.conference.nameCNS as Interal Consultant: Influencing Local to Global Systemsen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPortland, Oregon, USAen_US
dc.descriptionConference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USAen_US
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.en_US
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