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Showing 9 results for Cardiac Surgery
Masoumeh Zakerimoghadam, Shahrzad Ghyasvandian, Kourosh Jodaki, Mohammad Khavasi,
Volume 3, Issue 3 (12-2014)
Abstract
Aim. The aim of this study was to examine the role of liaison nurse on vital signs of patients in the process of transition from cardiac surgery intensive care unit to general ward.
Background. Patients' transfer from intensive care unit to a general ward is accompanied by anxiety, stress and changes in patients' vital signs. It is said that the role of liaison nurse solve the problems between intensive care unit and the general ward and prevent adverse events during transfer of patients.
Method. This was a quasi-experimental study in which 68 patients were recruited and allocated to experimental and control group. In both control and experimental group, demographic and disease characteristics were collected in the beginning of the study .The experimental group received liaison nurse services during transfer process. Vital signs of the patients were measured and recorded at the beginning of transfer and two hours after admission of patient in the general ward. The data were analyzed by SPSS version 19 and using statistical tests.
Findings. Before intervention, the experimental and control group were homogeneous in terms of demographics and vital signs except for systolic blood pressure. After intervention, significant reductions were found in vital signs in the experimental group.
Conclusion. Liaison nurse services affect the vital signs of patients in the process of transition from cardiac surgery intensive care unit to general ward.
Masume Zakerimoghadam, Somayeh Asgari, Esmail Shariat, Hamid Haghani,
Volume 3, Issue 4 (3-2015)
Abstract
Aim. The aim of this study was to evaluate the current and expected status of comfort from the point of view of hospitalized cardiac surgery patients.
Background. Providing comfort for the patient is one of the most important aspects of nursing that should be considered in all aspects of care as the top nursing care priority.
Method. This was a descriptive comparative cross-sectional study in which 292 patients undergoing cardiac surgery were recruited as study sample. Data collection tool was a demographic form and modified form of Kolcaba's comfort questionnaire evaluating the current and expected status of comfort. After that the reliability and validity of the questionnaire was confirmed, it was completed by interview, the second day after surgery. Data analysis was performed by SPSS, version 16.
Findings. The participants reported the best current status of comfort in psychospiritual (63.57 percent) and sociocultural (62.71 percent) domains of comfort, and rated physical domain of comfort as the lowest one(36.64 percent). Patients reported the comfort status in the environmental domain as moderate (54.78 percent). The most expectation of the patients were to be provided with comfort in psychospiritual (92.02 percent), environmental (91.14 percent) and physical (90.96 percent) domains, respectively, and the provision of comfort in sociocultural domain were least expected (88.16 percent). There was a statistically significant relationship of comfort with gender, age, education, occupation, place of residence, income, number of family members, physical activity and history of heart surgery, hypertension and hyperlipidemia.
Conclusion. Patients reported less comfort in the physical domain and the most expected domain of comfort was psycho-spiritual. It is recommended that nurses pay more attention to providing comfort in physical and psychospiritual domains.
Mohammad-Ziae Totonchi, Rasoul Azarfarin, Hoda Jorfi,
Volume 3, Issue 4 (3-2015)
Abstract
Aim. This study aimed to evaluate the effect of preoperative cardiac surgery nursing care education on anx-iety, quality of sleep, fasting time and cardiac medication usage in cardiac surgery patients.
Background. Cardiac surgery is one of the most important therapeutic approaches in patients with heart diseases. According to previous studies it is necessary to reduce the anxiety level and improve the quality of sleep the night before surgery, fasting according to standard protocols and continuing usage of cardiac medications.
Method. This study was a quasi-experimental trial in which patients were studied in two groups (before-training group and after-training group). One hundred cardiac surgery patients were selected based on in-clusion criteria as before-training group and evaluated in terms of anxiety level, quality of sleep, fasting time and cardiac medication usage in the night before surgery. Sampling lasted for 42 days. Then, all of the surgical nurses were trained individually for a week, and given pamphlets. Their educational content in-cluded the latest fasting protocols, non-pharmacological methods of reducing anxiety and improving quality of sleep and emphasizing on the importance of cardiac medication usage in the night before surgery. Then, another 100 patients were evaluated as the after-training group. Sampling from this group lasted for 38 days. The tools included demographic sheet and Spielberger anxiety questionnaire. Data were analyzed with SPSS software.
Findings. The findings of this study showed a statistically significant difference in anxiety level between before-training group and after-training group (P<0.0001). Also, there was a significant statistical differ-ence in quality of sleep between two groups (P=0.004). But, there was not a statistically significant differ-ence in fasting hours and cardiac medication usage between two groups.
Conclusion. According to the findings, educating preoperative cardiac surgery nursing care decreased anxi-ety level and improved quality of sleep in after-training group. But this intervention neither decreased fast-ing hours nor increased continuing cardiac medication usage in after-training group.
Nahid Aghdaii, Zahra-Sadat Navabi, Rasoul Azarfarin,
Volume 4, Issue 2 (9-2015)
Abstract
Aim. The aim of this study was to evaluate the effect of using “Pain Assessment Tool” by nurses on analgesics requirement and patient’s satisfaction after coronary bypass graft surgery.
Background. One of the main duties of caregivers in ICU is relieving patients’ pain. Using "Pain Assessment Tool" may have a positive effect on the choice of analgesics and dosage adjustment with patients’ requirements. More research is still needed.
Method. In a clinical trial, 153 hospitalized patients in the intensive care unit were selected randomly and were divided into two experimental (n=77) and Control group (n=76). The Pain Assessment Tool and pain management for 48 hours were implemented for conscious patients. Routine measures were taken into account for control group and the severity of pain and analgesic injection for experimental group were determined. In both groups, the amount of analgesics administered for pain relief, and patient satisfaction were recorded. Data were analyzed by SPSS version 16.
Findings. The use of Pain Assessment Tool increased the number of recipients of analgesic drugs and reduced their dosage over 48 hours in the experimental group. Also, the satisfaction of pain relief was higher in the experimental group than the control group (p<0.0001).
Conclusion. The findings of this study demonstrate the positive effect of Pain Assessment Tool on pain control, proper use of analgesics, prescribing the proper dose of analgesics based on patients’ pain and satisfaction improvement. The measurement of pain severity using Pain Assessment Tool, before and after analgesics administration is suggested.
Mostafa Alavi, Tooraj Babaee, Mahshid Ghadrdoost, Alireza Azad,
Volume 4, Issue 4 (3-2016)
Abstract
Abstract Aim.This study aimed to compare pulse pressure variation (PPV) with central venous pressure (CVP) in checking out and optimizing fluid volume in mechanically ventilated patients admitted to intensive care unit after cardiac surgery. Background.In clinical area, assessment of body fluid and determination of the intravascular volume after major surgeries such as heart surgery is a significant challenge. The initial purpose of intravascular volume assessment in patients with hemodynamic instability is to determine whether they would benefit from fluid administration or not. Method. In the present study a prospective descriptive-analytic design was used. Thirty mechanically ventilated patients admitted to intensive care units of Rajaee Heart Center, Tehran, Iran, were recruited in the study after cardiac surgery based on inclusion criteria. Data collection tools included demographic and clinical data sheets. Hemodynamic parameters such as CVP, systolic and diastolic pressures (for calculating pulse pressure and its variation) were recorded by bedside monitoring. Cardiac Index (CI) was measured by non invasive continuous cardiac output monitoring (NICCOMO) system. Data were analyzed in SPSS version 20, using statistical tests. Findings. The mean changes of CVP, before and five minutes after fluid administration, were significantly different (10.10±6.01 mmHg and 12.37±6.34 mmHg, respectively, p=0.015). The mean changes in arterial pulse pressure, before and five minutes after fluid administration, were significantly different (16.94±8.32 mmHg and 12.77±4.02 mmHg, respectively, P=0.005). At the cut point 2.8 lit/min/m2 for CI, the sensitivity and specificity values for PPV>13%, were 0.71 and 0.61, respectively. Also, at the same cut point, the sensitivity and specificity values for CVP<5mmHg, were 0.11 and 0.84, respectively. These findings suggest a higher diagnostic power of PPV compared to CVP to assess fluid volume. Conclusion.It seems that in the mechanically ventilated patients after heart surgery, PPV dynamic index is preferred to CVP static index to evaluate and maintain fluid volume.
Farzaneh Hasanzadeh, Zohreh Mohamadzadeh-Tabrizi, Shahram Amini, Javad Malekzadeh, Seyed Reza Mazloom, Zahra Parsaei-Mehr,
Volume 6, Issue 3 (12-2017)
Abstract
Aim. The aim of this study was to assess the causes of dysfunctional ventilatory weaning response after cardiac surgery
Background. One of the most important complications after cardiac surgery is the prolonged mechanical ventilation, because it is associated with the increase in mortality (30-40%). Extubation of endotracheal tube within the 6 hours post operation is considered as a gold standard improving heart function, increasing patients’ comfort, decreasing respiratory complication, and decreasing cost and hospitalization. The prolonged mechanical ventilation and dysfunctional ventilatory weaning response (DVWR) are the risk factors for cardiac surgery and controlling and preventing them is necessary.
Method. This was a descriptive cross-sectional study in which 80 patients admitted to Cardiac Surgery Department of Imam Reza Hospital in Mashhad were selected within a 4 months period by convenience sampling method. Patients with mechanical ventilation over 6 hours were recruited. Data were analyzed in SPSS software.
Findings. DVWR was significantly associated with smoking (p=0.03), and delayed recovery from anesthesia was the most common reason associating with DVWR (55.3%).
Conclusion. By controlling factors of the DVWR, we can reduce the duration of mechanical ventilation.
Fatemeh Asgari, Frank Kargar, Farzaneh Fotouhi, Shiva Khaleghparast,
Volume 8, Issue 1 (3-2019)
Abstract
Abstract
Aim. This study aimed at examining the effect of preoperative fluid therapy on kidney function in patients undergoing heart surgery.
Background. As one of surgery complications, kidney failure occurs with oliguria and rise in creatinine. Decreased heart output leads to reduction in renal perfusion. Acute renal failure is associated with increase in morbidity, mortality and high medical treatment cost. Various studies has indicated an increase in postoperative mortality rate when complications of acute renal failure superimpose the situation. One of the best strategies for kidney protection is optimizing preoperative hemodynamics and fluid therapy.
Method. In this clinical trial study, 107 patients were recruited based on inclusion criteria and randomly allocated to experimental (n=54) and control (n=53) group. Patients in experimental group received Half- Saline, 1cc/kg/hr, during 12 hours before surgery. Patients in control group started as being NPO, 8 hours before the surgery. Creatinine level, BUN, and 24-hours urine output were measured and recorded during two days after surgery. Data were analyzed in SPSS V.22 using descriptive and inferential statistics.
Findings. The groups didn't differ in terms of age, gender, weight, and ejection fraction. There was no statistically significant difference between experimental and control group in terms of creatinine changes during the preoperative day and the first and the second day after surgery. Also, there was no statistically significant difference between groups in BUN on the first and second days after surgery. The urine output of the experimental group was greater than control group on first and second days after operation, but the difference was not significant. The duration of ICU stay were similar in both groups. There were recorded two deaths in control group while there was no death in experimental group.
Conclusion. It was concluded that preoperative fluid therapy has no short-term effect on kidney function. It is recommended to examine the effect of fluid therapy on kidney function in longer periods.
Marzee Eskandari Hesari, Faezeh Sahbaeiroy, Jamile Mohatshami, Maryam Moradian,
Volume 11, Issue 1 (3-2022)
Abstract
Abstract
Aim. The aim of this study was to design and examine the psychometrics of post-traumatic stress disorder tool for children undergoing heart surgery
Background. Heart disease is one of the most important health issues and traumatic events that cause great harm to children, one of which is the experience of surgery. Therefore, we need a standard tool to assess post-traumatic stress disorder in children.
Method. In this methodological study, researchers compiled a questionnaire for measuring post-traumatic stress disorder in children undergoing heart surgery. The questionnaire was provided to 10 experts to examine the validity. In the next step, 40 items, revised by experts, were examined for construct validity and reliability based on the responses of 200 children 12-18 years old to questionnaire. The data were analyzed in SPSS version 24 and LISREL version 10.
Findings. After preparing the draft, the questionnaire was given to 10 experts to determine face and content validity. For face validity, the impact score of the items was computed and due to similar meaning of some items they were merged. In order to determine the content validity, two indexes of content validity ratio (CVR) and content validity index (CVI) were considered. According to Lauche's table, items with a content validity ratio less than 0.62 were excluded (7 items), items with a content validity ratio greater than 0.79 were accepted, and items with a content validity ratio between 0.70 and 0.79 were revised. In the construct validity stage, to ensure the sufficient sample size, the Kaiser-Meier-Elkin (KMO) test was performed and the results of Bartlett's Sphericity test were significant (P≤0.0001). Finally, exploratory factor analysis was performed with Varimax rotation on 40 items, and 7 items with a factor loading of less than 0.4 were removed, and in the end, 33 items remained. To determine the reliability of the questionnaire using the internal consistency method, Cronbach's alpha of the questions were computed and it was above 0.80 for all items. The test-retest results confirmed the significant relationship between the pre-test and post-test scores in 7 factors of the questionnaire (P≤0.0001).
Conclusion. In order to achieve more accurate results in research, it is necessary to use valid and reliable tools. The results of this study showed the strength of the factor structure and acceptable reliability of the post-traumatic stress tool for children undergoing heart surgery. The tool designed in this study is valid and reliable and can be used to determine post-traumatic stress in children undergoing heart surgery.
Sara Lotfian, Hasan Arian, Rasool Azarfarin, Hooman Bakhshandeh, Pardis Moradnejad,
Volume 11, Issue 1 (3-2022)
Abstract
ABSTRACT
Aim. The aim of the present study was to examine the effect of early mobilization protocol on the strength of diaphragmatic muscle and other inspiratory muscles after open heart surgery.
Background. Early mobilization is recommended as a safe protocol after open heart surgery to decrease hospital stay and post-op respiratory complications; however, our knowledge about its effect on improving respiratory muscles strength is limited.
Methods. This is a randomized single-blinded clinical trial conducted on 80 consecutive patients who underwent coronary artery bypass surgery and/or valvular surgery that were randomly assigned to experimental group (postoperative early mobilization) and control group (routine physiotherapy). On the day before surgery and the day before leaving intensive care unit (ICU), two scores were measured for assessing diaphragmatic muscle strength: maximum inspiratory pressure (PI max) and Strength index (S index). Hemodynamic parameters were also measured and compared.
Findings. According to both PI max and S index, diaphragmatic muscle strength decreased from 77.28 to 59.53 cmH2O in patients after surgery, but the changes in the experimental group was less than the control group, which indicates a significant improvement in the strength of the diaphragm muscle in the experimental group (p≤0.0001). Hemodynamic changes after surgery (lower blood pressure and increased heart rate) occurred in both groups without any significant clinical effect.
Conclusion. Early mobilization after cardiac surgery has positive effect on the strength of diaphragmatic muscle and is also safe as shown to have no adverse effect on hemodynamic parameters.
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