Savage L S, Grap M J
Medical College of Virginia Hospitals, Richmond, USA.
Am J Crit Care. 1999 May;8(3):154-9.
Monitoring the postoperative course of cardiac surgery patients remains essential but requires creative strategies now that length of hospitalization has been shortened to 5 days or less.
To determine patients' concerns in the early recovery period after open-heart surgery and to describe the impact of advanced practice nurses on this phase of recovery.
A cardiovascular clinical nurse specialist conducted follow-up by telephone for 342 cardiac surgery patients 7 to 14 days after discharge. Patients were asked both open-ended and direct questions.
The major problems were leg edema (48%), appetite disturbance (35%), dyspnea (29%), sleep disturbance (12%), and wound drainage (9%). The nurse's interventions over the telephone included reassuring the patient about postoperative progress (86% of sample), giving diet information (31%), instructing about activity (29%), providing emotional support (25%), referring for medical treatment (16%), and explaining medications (13%). In response to these findings, the nursing practice council revised postoperative teaching to emphasize wound healing, sleep, and appetite issues.
Telephone monitoring of cardiac surgery patients after early discharge can alleviate the often stressful transition to postoperative recovery at home. A cardiovascular clinical nurse specialist can provide patients and patients' family members with reassurance and ongoing reinforcement of the discharge information.
鉴于心脏手术患者的住院时间已缩短至5天或更短，监测其术后病程仍然至关重要，但需要创新策略。
确定心脏直视手术后早期恢复期患者的担忧，并描述高级执业护士对这一恢复阶段的影响。
一名心血管临床护士专家在342例心脏手术患者出院后7至14天通过电话进行随访。向患者提出了开放式和直接问题。
主要问题有腿部水肿（48%）、食欲紊乱（35%）、呼吸困难（29%）、睡眠障碍（12%）和伤口引流（9%）。护士通过电话进行的干预包括让患者放心术后进展（样本的86%）、提供饮食信息（31%）、指导活动（29%）、提供情感支持（25%）、转诊治疗（16%）和解释药物（13%）。针对这些发现，护理实践委员会修订了术后教学内容，以强调伤口愈合、睡眠和食欲问题。
对早期出院的心脏手术患者进行电话监测可以缓解在家中向术后恢复过渡时常常出现的压力。心血管临床护士专家可以让患者及其家属放心，并持续强化出院信息。
