Meeting educational and clinical nursing objectives with a collaborative research utilization project.
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Biomedical subjects
Publications and source records attributed to A G Strong.
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Clinical decision making about postoperative dysrhythmias requires the specialized skills and knowledge of the critical care nurse. During the immediate postoperative period, the critical care nurse must be aware of physiologic alterations and factors that may predispose the cardiac surgery patient to dysrhythmias. Correction of these physiologic alterations is usually the first step in postoperative dysrhythmia management. Should dysrhythmias develop following cardiac surgery, the critical care nurse may use management options that are not available in other surgical or medical patients. AEGs and pacing to suppress ectopy, to augment cardiac output, or to overdrive tachydysrhythmias are some of the available options. The advent of external, temporary DDD pacing will augment these management options. The challenges presented by these options emphasize the vital role of the critical care nurse in postoperative dysrhythmia management.
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The critical path, one component of the case management model, was examined to determine its accuracy in describing patient recovery following coronary artery bypass surgery and to determine if variations from the path influenced postoperative length of stay. One hundred ninety-five (195) postoperative days were analyzed on 28 subjects. Data about patient characteristics, daily progress, and recovery following transfer from intensive care until hospital discharge were compared to expected patient progress and recovery as delineated by the critical path. Fifty-seven percent (57%) of the patients (n = 28) were discharged within the time frames designated by the critical path. Significant correlations (p less than or equal to .01) were found between postoperative length of stay and the variables of activity progression (r = -.46), telemetry usage (r = -.56), inspirometer use (r = -.35), and adherence to the critical path (r = -.48). Using step-wise multiple regression analysis, overall adherence to the critical path in the areas of telemetry usage and activity progression were found to be significant predictors of postoperative length of stay (combined R2 = .65).