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Based on C-CHEWS study on the application value of comprehensive perioperative nursing based on scoring in critically

Feifei Li1, Aifang Mao1, Xiaomei Niu1

  • 1Department of Pediatric Cardiovascular Surgery, Anhui Hospital, Children's Hospital Affiliated to Fudan University, Anhui Provincial Children's Hospital, Hefei, China.

Frontiers in Pediatrics
|September 18, 2025
PubMed

Insights

Comprehensive perioperative nursing, utilizing the Children's Cardiovascular Early Warning Scale (C-CHEWS) score, significantly improved outcomes for critically ill children undergoing cardiovascular surgery. This approach led to shorter hospital stays, fewer adverse events, and enhanced family satisfaction.

Area of Science:

  • Pediatric cardiovascular surgery outcomes
  • Critical care nursing interventions
  • Patient safety in pediatric surgery

Background:

  • Critically ill children undergoing cardiovascular surgery face significant risks.
  • Early identification of clinical deterioration is crucial for improving patient outcomes.
  • Standard perioperative nursing may not always ensure timely detection of critical changes.

Purpose of the Study:

  • To evaluate the impact of comprehensive perioperative nursing, including the Children's Cardiovascular Early Warning Scale (C-CHEWS) score, on outcomes in pediatric cardiovascular surgery patients.
  • To compare outcomes between patients receiving routine care and those receiving comprehensive nursing care with C-CHEWS integration.
  • To assess the association of this nursing model with hospital stay, ICU monitoring, disease control, quality of life, adverse events, and family satisfaction.

Main Methods:

  • Observational study of 120 children with congenital heart disease undergoing cardiovascular surgery (March 2020-March 2022).
  • Patients divided into routine care and comprehensive care groups (including C-CHEWS scoring).
  • Key outcomes measured: hospital stay, ICU time, disease status, quality of life, adverse events, and family satisfaction.

Main Results:

  • Comprehensive care group showed significantly shorter ICU monitoring and hospitalization durations (P<0.05).
  • Higher disease control rates (76.67% vs 30.0%) and improved quality of life scores were observed in the comprehensive care group (P<0.05).
  • Adverse events were significantly lower (10.00% vs 46.67%) and family satisfaction higher (96.67% vs 70.0%) with comprehensive care (P<0.05).

Conclusions:

  • Comprehensive perioperative nursing, incorporating the C-CHEWS score, enhances early detection of deterioration in pediatric cardiovascular surgery patients.
  • This nursing model is associated with reduced adverse events, shorter hospital stays, and increased family satisfaction.
  • The findings support the adoption of this comprehensive nursing approach in clinical practice for improved pediatric surgical outcomes.
Abstract

Keywords:
C-CHEWS scorecardiovascular surgerycomprehensive nursingcritically ill childrenearly identification

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