Nurse-led postoperative interventions in adult cardiac surgery: a systematic review

The primary aim of this systematic review was to identify nurse-led clinical interventions evaluated in randomised controlled trials (RCT) for adults who had undergone cardiac surgery. The secondary aim was to assess the effectiveness of these interventions on postoperative clinical and patient-reported outcomes during the acute inpatient phase.

A systematic review was undertaken according to an a priori protocol using Joanna Briggs Institute (JBI) methodology and PRISMA guideline for reporting. Eligible studies were RCT of adult (≥18 years) cardiac surgery, nurse-led inpatient interventions implemented immediately post-surgery and prior to discharge. Six databases were searched from inception to June 2025. Of 2,690 records, 19 RCT were eligible, representing 13 countries, and 3,142 participants. Risk of bias varied, with only two low risk trials. Interventions were grouped into six domains: behavioural support; temperature management and comfort strategies; pain and symptom management; wound care and infection prevention; respiratory and pulmonary function; and postoperative recovery, mobilisation, and hydration. Across these domains, nurse-led interventions were generally feasible, safe, and positively affected patient comfort, physiological stability, symptom relief, and aspects of functional recovery.

Nurse-led inpatient interventions contribute meaningfully to in-patient postoperative recovery in cardiac surgery, although the broader cardiac surgical nursing scope is underrepresented in RCT. This review provides a foundation for developing further high-quality research, peer-reviewed interdisciplinary practice guidelines, and strengthening the scope and recognition of cardiac surgical nursing as a distinct specialty.