The CNS and Evidence-Based Practice: Implementing a Peri-operative Beta-blockade Therapy Program

2.50
Hdl Handle:
http://hdl.handle.net/10755/164372
Category:
Abstract
Type:
Presentation
Title:
The CNS and Evidence-Based Practice: Implementing a Peri-operative Beta-blockade Therapy Program
Author(s):
Cos, Erin; Brush, Kathryn Ann; Martin, Ann T.
Author Details:
Erin Cos, MS, RN, CCRN, CS, Massachusetts General Hospital, Boston, Massachusetts, email: nacnsorg@nacns.org; Kathryn Ann Brush MS, RN, CCRN, FCCM; Ann T. Martin MSN, RN, CS-ANP
Abstract:
Significance: Myocardial events are the most common medical complication of surgery, occurring in 2-5% of patients undergoing non-cardiac surgery and 30% for patients undergoing vascular surgery. For patients who suffer cardiac ischemia/infarction during surgery, the mortality rate is nearly 60%. Description of Practice Change: A multidisciplinary team strategized how to safely and effectively incorporate cardioprotective beta blaocker therapy into practice. Beta blockade was initiated in the pre-operative area and continued through discharge. Purpose: Improve outcomes for surgical patients while preserving safety in practice. Methods 1) Computer order entry including a) guidelines for therapy extended from the immediate preoperative period through dosing after discharge and b) template orders which included hold parameters and dosing for oral and intravenous therapy. 2) Education including a) educational sessions and reference material created for physicians and nurses, b) focused educational offerings included identifying candidates for beta blockade prophylaxsis, rationale of treatment guidelines, monitoring requirements and antidotes to therapy, c) patient education materials to assist the nurse with discharge planning and instructions. 3) Safety in practice including a) cardiac monitoring requirement for intravenous beta blocker therapy and b) institutional guidelines specifying that physicians must administer intravenous beta blockade therapy outside of and intensive care unit. Conclusion: As the scope of nursing practice continues to grow, the CNS becomes even more integral to the development of change processes which are focused on patient and clinician safety. Future work will look at outcomes associated with prophylactic beta-blocker therapy, obstacles to administration of the medication and possible expansion of nursing practice in the administration of intravenous beta-blocker therapy to RNs outside of the ICU.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
CNS Leadership: Navigating the Healthcare Environment Toward Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Orlando, Florida, USA
Description:
Conference theme: CNS Leadership: Navigating the Healthcare Environment Toward Excellence, held on March 9�12, 2005 in Orlando, Florida, 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.titleThe CNS and Evidence-Based Practice: Implementing a Peri-operative Beta-blockade Therapy Programen_GB
dc.contributor.authorCos, Erinen_US
dc.contributor.authorBrush, Kathryn Annen_US
dc.contributor.authorMartin, Ann T.en_US
dc.author.detailsErin Cos, MS, RN, CCRN, CS, Massachusetts General Hospital, Boston, Massachusetts, email: nacnsorg@nacns.org; Kathryn Ann Brush MS, RN, CCRN, FCCM; Ann T. Martin MSN, RN, CS-ANPen_US
dc.identifier.urihttp://hdl.handle.net/10755/164372-
dc.description.abstractSignificance: Myocardial events are the most common medical complication of surgery, occurring in 2-5% of patients undergoing non-cardiac surgery and 30% for patients undergoing vascular surgery. For patients who suffer cardiac ischemia/infarction during surgery, the mortality rate is nearly 60%. Description of Practice Change: A multidisciplinary team strategized how to safely and effectively incorporate cardioprotective beta blaocker therapy into practice. Beta blockade was initiated in the pre-operative area and continued through discharge. Purpose: Improve outcomes for surgical patients while preserving safety in practice. Methods 1) Computer order entry including a) guidelines for therapy extended from the immediate preoperative period through dosing after discharge and b) template orders which included hold parameters and dosing for oral and intravenous therapy. 2) Education including a) educational sessions and reference material created for physicians and nurses, b) focused educational offerings included identifying candidates for beta blockade prophylaxsis, rationale of treatment guidelines, monitoring requirements and antidotes to therapy, c) patient education materials to assist the nurse with discharge planning and instructions. 3) Safety in practice including a) cardiac monitoring requirement for intravenous beta blocker therapy and b) institutional guidelines specifying that physicians must administer intravenous beta blockade therapy outside of and intensive care unit. Conclusion: As the scope of nursing practice continues to grow, the CNS becomes even more integral to the development of change processes which are focused on patient and clinician safety. Future work will look at outcomes associated with prophylactic beta-blocker therapy, obstacles to administration of the medication and possible expansion of nursing practice in the administration of intravenous beta-blocker therapy to RNs outside of the ICU.en_GB
dc.date.available2011-10-27T11:47:10Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:47:10Z-
dc.conference.date2005en_US
dc.conference.nameCNS Leadership: Navigating the Healthcare Environment Toward Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.descriptionConference theme: CNS Leadership: Navigating the Healthcare Environment Toward Excellence, held on March 9�12, 2005 in Orlando, Florida, 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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