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The best nursing care in cardiac surgery


With the objective of performing more than 1850 cardiac surgeries in 2004-2005, the operating room teams, the surgical intensive care unit and the surgical unit offer quality ultra-specialized care to patients referred from other hospitals, other care units or the pre-admission clinic.

 

 

 

Two nurses of the surgical intensive care unit
Operating Room

Supervised by the operating room and sterilization co-ordinator, the operating room team includes nurses (including a first assistant nurse), an assistant head nurse, a management agent, a secretary, a desk clerk, orderlies and sterilization and maintenance employees. This team works in close collaboration with the surgeons, anaesthetists, perfusionists and respiratory therapists. The surgical intensive care unit (24 beds, including the recovery room) and the surgical unit (29 beds) are located on the 3rd floor of the Institute. The team provides patients with a complete range of care services before and after cardiac surgery.

The operating theatre has four rooms that are used to maximum capacity, making it possible to reach the target of 40 surgeries per week. Cancelled surgeries are rare because of the tremendous mobilization of all of the teams involved, the efficient management of the surgical beds, and an innovative approach to systematic patient follow-up

Surgical Intensive Care Unit

The Surgical Intensive Care Unit, which was recently renovated, is an open unit with 24 beds (including the recovery room), and full monitoring. The unit's nurses have developed extensive expertise in various areas of critical intervention, including hemofiltration and hemodialysis (a specially trained team of nurses), invasive cardiovascular monitoring, and intra-aortic balloon pumpss. Aided by orderlies trained in intensive care, these nurses work as part of a team of surgeons, anesthetists, general practitioner-intensivists, consultants, respiratory therapists, physiotherapists, and nutritionists in order to optimize patient care and length of stay.

With an interdisciplinary process for extubation and pain control, the teams aim to limit post-operative intubation to fewer than 6 hours, and length of stay in the unit to fewer than 48 hours. A process for interdisciplinary intervention planning was introduced for patients who have an extended stay in the unit.

Surgical Unit

The Surgical Unit has 29 beds, and a telemetry monitoring system (18 telemetry units). Cardiac surgery patients are ensured continuity of care pre- and post-operatively. Unit nurses coordinate pre-operative teaching sessions with the interdisciplinary team. There is a full-time clinical pharmacist, which improves the effectiveness with which medications are prescribed, helps ensure secondary prevention, and provides clinical support to the nurses.

Cooperation among all members of the interdisciplinary team, and the application of rigorous case management ensures that patients receive quality care, as evidenced by the results of the latest satisfaction survey: patients expressed an overall satisfaction rate of 93.8% (September to November 2004).

The Intensive Care Unit and Surgical Unit are supervised by the surgical care units coordinator and assistant coordinator. These units include 102 nurses and 29 orderlies.

Case management in cardiac surgery

Case management in cardiac surgery is the result of a concerted effort. The three graduate nurses and the secretary, under the supervision of the coordinator of specialized clinics and systematic follow-up, work together with all members of the surgical team, the interdisciplinary team, and internal and external partners, to meet the needs of cardiac surgery patients through general case management prior to, during and following hospitalization.

The objectives sought through this case management are:

  • To favour the achievement of results; to reduce the length of stay, the number of return visits to emergency and of re-admissions.
  • To ensure the optimal use of resources.
  • To improve coordination and continuity of care.
  • To ensure better discharge planning.
  • To ensure the satisfaction of the patient and their family and those involved in their care.
  • To ensure quality of care.
  • To encourage communication dialogue and interdisciplinary effort.

Office: (514) 376-3330, extension 4062

 

 © Montréal Heart Institute - 2007