How to Start an Enhanced Recovery After Surgery Cardiac Program
Oliver K Jawitz1, William T Bradford2, Gina McConnell2
1Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Box 3443, Durham, NC 27710, USA; Duke Clinical Research Institute, Duke University Medical Center, Box 3443, Durham, NC 27710, USA. Electronic address: https://twitter.com/ojawitzMD.
Critical Care Clinics
|September 7, 2020
Summary
Implementing an enhanced recovery after surgery (ERAS) cardiac surgery program requires a multidisciplinary team and a dedicated coordinator. Developing an institution-specific protocol ensures successful program initiation and patient care improvements.
Area of Science:
- Cardiology
- Surgical Care
- Healthcare Management
Background:
- Enhanced recovery after surgery (ERAS) protocols optimize patient outcomes.
- Cardiac surgery presents unique challenges for ERAS implementation.
- Standardized approaches are needed for successful ERAS cardiac surgery program initiation.
Purpose of the Study:
- To present a practical framework for establishing ERAS cardiac surgery programs.
- To guide healthcare institutions in developing and implementing ERAS protocols for cardiac surgery.
- To highlight key components for successful ERAS cardiac surgery program initiation.
Main Methods:
- Formation of a dedicated multidisciplinary ERAS cardiac team.
- Appointing a program coordinator or navigator.
- Development of institution-specific protocols based on national guidelines and local expertise.
Main Results:
- A structured, practical approach to ERAS cardiac surgery program initiation is outlined.
- Key roles and responsibilities for program success are defined.
- Emphasis on multidisciplinary collaboration and tailored protocols.
Conclusions:
- Successful ERAS cardiac surgery programs depend on a coordinated, multidisciplinary team.
- A dedicated program coordinator is crucial for effective implementation and monitoring.
- Institution-specific protocols are essential for adapting ERAS principles to cardiac surgery.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
132
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
132
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
165
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
165
01:29Appendicitis-II: Diagnostic Studies and Management
317
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
317
01:19Restorative Care
2.2K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.2K
01:29Cardiomyopathy V: Interprofessional Care
181
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
181
01:23Peripheral Artery Disease V: Postoperative Nursing Management
197
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
197