Nursing in a Cardiac OT

8/7/2019 Nursing in a Cardiac OT

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NURSING IN A CARDIAC OT

BY

SRIMATHIMIOT

HOSPITALS

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` Cardiac surgery is a surgery on the heart and/orgreat vessels

performed by a cardiac surgeons.

` Done to treat complications of Ischemic heart disease

(forexample, Coronary Artery Bypass Grafting),

correct Congenital Heart Disease orValvularHeart Disease caused by various causes

including Endocarditis.

` It also includes Heart Transplantation.

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` The development ofcardiac surgery and cardiopulmonarybypass techniques hasreduced themortalityrates of thesesurgeries to relativelylow ranks. Forinstance,repairs ofcongenital heart defects are currentlyestimated to have 4-6%mortalityrates.

` A majorconcern with cardiac surgeryis theincidenceofneurological damage. Stroke occursin 2-3% ofall peopleundergoing cardiac surgery, and is higherin patients at riskforstroke.A moresubtle constellation ofneurocognitivedeficits attributed to cardiopulmonary bypass is knownas postperfusion syndrome (sometimes called 'pumphead').

` Thesymptoms ofpostperfusion syndrome wereinitiallyfelt tobe permanent, but wereshown to be transient with nopermanent neurologicalimpairment.

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A majorconcern with cardiac surgeryis theincidence

ofneurological damage.

Stroke occursin 2-3% ofall peopleundergoing cardiac

surgery, and is higherin patients at risk forstroke A more

subtle constellation ofneurocognitive deficits attributed

to cardiopulmonary bypass is known as postperfusion

syndrome (sometimes called 'pumphead').

Thesymptoms ofpostperfusion syndrome wereinitially

felt to be permanent, but wereshown to be transient with

no permanent neurologicalimpairment.

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` Cardiac surgery nurses, also referred to as cardiovascular

nurses, work in a hospital and careforpatients who undergo cardiac

surgery.

` These professionals work with patients ofall ages, although

cardiovasculardisease and cardiac illnesses typically affect elderlypatients.

` They areinvolved with all phases ofcardiac surgery by caringfor

patients before, during and aftertheirsurgical procedures.

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` Cardiac nurses are highlyspecialized nursingstaffwho

have additional acquired knowledgein thefield of

cardiology.

` Nurses of thissort are based in operating theatres

outpatient cardiology departments,intensive careunits,

coronary careunits, cardiac catheterization labs and

surgical wards.

` Some nursesmay also be presented with opportunities

to work primarilyin research.

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` Pre-Operative Responsibilities

` Operative Responsibilities

` Post-Operative Responsibilities

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Pre-operative careincludesevaluating a patient'sreadinessforsurgery by taking a detailed medicalhistory and performing a complete physicalexamination.

Thisisfollowed by ordering appropriate testsfor

assessment and prescribing necessarymedicationsforsurgery.

It includes preparing the pt. physically and mentally.

Pre op caremainlyincludes properconsent, and ifnecessary high risk consent too.

The blood statusis checked.

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` Operativeresponsibilitiesinclude assistingin

preparation of the patient by positioning the

patient on the operatingroom table and applying

appropriate drapingforthesurgical procedure.Assisting the cardiac operation as needed by a

surgeon is also required.

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` Post-operative careincludesevaluating the patient'srecovery

process by checking vitalsigns, administeringintravenouslines,

orderingmedications and laboratory tests as needed and monitoring

the patient to ensure there are no complications aftersurgery.

` Ourprofessionals also identifyemergencysituations and follow

established proceduresin response to an emergency.

` This can include administering advanced lifesupport ormedication

and contacting attending and on-callmedicalstaffto respond.

(contd)

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(contd)

` Many hospitals have a cardiac step-down unit where cardiac

surgery patients are often transferred afterthey've passed the

critical phase ofrecovery.` Cardiac surgery nurses often continue to work with patients after

they have been transferred to theunit to ensure a continuous and

successfulrecovery.

` Allresponsibilities are accomplished on a daily basisuntil a patient

is discharged, and includesinitiating discharge planning by

completing allrequired forms and prescriptionsforreview by the

patient'ssurgeon orpost-operative physician.

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` Provide betteroutcomesforpatients byimproving

theservice and quality.

` Strengthen leadership and teamwork.

` Roles are constructed to satisfy the needs ofindividual Surgical procedures.

` Follow strict Aseptic techniques throughout the

surgery.

` Supporting & Educating Staff.

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` Infection prevention in the operatingroomis

achieved through prudent use ofaseptic

techniquesin order to:

` Prevent contamination of the open wound.

` Isolate the operativesitefrom thesurrounding

unsterile physicalenvironment.

` Create and maintain a sterilefield in which

surgery can be performed safely.

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` Properly preparing a client forclinicalprocedures

` Hand washing

`

Surgical hand scrub` Using barrierssuch asgloves

and surgical attire

` Maintaining a sterilefield

` Usinggood surgical technique` Maintaining a safeenvironment

in thesurgical/procedure area

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` Hand Hygiene by Surgical Handwash.

` P

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` Protective MeasuresforUsein the OperatingTheatre Masks

Gowns Sterile Drapes Scrub suits Surgical caps and Hoods Eye protection and face shields Footwear Surgical gloves

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` Placing onlysterileitems within thesterilefield.

` Opening, dispensing, or transferringsterileitems

without contaminating them;

` Consideringitemslocated below thelevel of thedraped client to beunsterile;

` Not allowingsterile personnel to reach across

unsterile areas orvice versa or to touch unsterile

items;

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` Recognizing and maintaining theservice providerssterile area.

` When gowned this area extendsfrom chest to thelevel of the

` sterilefield;sleeves aresterilefrom5 cm above theelbow to the

cuff.

` The neckline,shoulders, and back are considered to be unsterile

areas ofthegown.

` Recognizing that theedges ofa package containing a sterileitem

are considered unsterile;

Sterile

Not Sterile

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` Recognizing that a sterile barrierthat has been

penetrated (wet,cut or torn)isconsidered

contaminated;

` Being conscious ofwhereyourbodyis at all timesand moving within oraround thesterilefield ina

way that maintainssterility;

` Not placingsterileitems nearopen windows or

doors.

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` Location of the Operating Theatre Suites

` Layout of the Operating Theatre

` The outer zone

` The clean or semi-restricted zone` Aseptic or restricted area

` Temperature and Humidity

` Ideal Air Ventilation System: Air Supply and

Exhaust

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` Equipment

` Waste and Linen

` Environmental Cleaning of the OT

` Maintenance in the OT` Environmental microbiologic sampling in the

OT

` Theatre sterile services unit (TTSU)

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` Discipline ofNursing: Conceptual and TheoreticalBasis

` Nursing Ethics

` Principles ofNursing Research

` Epidemiology

` Cardiac Risk Reduction/Exercise Therapy

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Documents

Nursing in a Cardiac OT