The best nursing care in cardiac surgery
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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.
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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:
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To favour the achievement of results; to reduce
the length of stay, the number of return visits to emergency
and of re-admissions.
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To ensure the optimal use of resources.
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To improve coordination and continuity
of care.
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To ensure better discharge planning.
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To ensure the satisfaction of the patient and
their family and those involved in their care.
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To ensure quality of care.
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To encourage communication dialogue and
interdisciplinary effort.
Office: (514) 376-3330, extension 4062
