Streamlining the Preoperative process for the Open Heart Surgery Patient

Written by Cynthia Havrilak, RN, MSN


Open heart surgery is considered to be a major event for patients, their families, and hospitals. Delays in surgery cause emotional distress forrepparttar patient and their family and are costly torepparttar 115158 hospital. For these reasons, it is beneficial for all organizations providing open heart surgery services to review their processes that preparerepparttar 115159 patient for open heart surgery. Investingrepparttar 115160 time to detailrepparttar 115161 patient flow processes involved inrepparttar 115162 preoperative preparation will assist in eliminating process gaps and identify opportunities to improve organizational communication, patient care and satisfaction. This can be accomplished by instituting a task force/ committee to assist in this area. It is advisable to include departments involved with patient entry points intorepparttar 115163 open heart process. These departments are usuallyrepparttar 115164 inpatient medical cardiac units, registration area, cardiovascular surgeon office, and cardiac cath lab. Development of standardized preoperative open heart surgery orders help to create common practice routines that can reduce errors, improverepparttar 115165 staff education, and reduce organizational costs by eliminating unnecessary tests and improving staff efficiencies. These benefits outweighrepparttar 115166 challenge of standardizing preoperative physician orders. The orders set should be approved byrepparttar 115167 appropriate organizational committees, explained torepparttar 115168 staff, and then distributive to appropriate departments for implementation. Included in these order sets should be preoperative lab tests, patient testing (CXR, EKG), medications, consults including anesthesia, and surgical prep. Input fromrepparttar 115169 medical staff is essential to this process. The administrative leader should be well versed on latest clinical techniques and cardiovascular research ensuring best practices are addressed and not overlooked. Some ofrepparttar 115170 most common causes of delays are from inaccurate completion of blood bank procedures, long turnaround times for patient reports, a lack ofrepparttar 115171 chest film or lateral view, scheduling delays for patient testing, and lost pieces ofrepparttar 115172 patient’s medical record. Addressing these topics during patient flow planning is essential in expeditingrepparttar 115173 presurgery process. Once process gaps are identified it is important to develop a workable solution and education plan. Ongoing continuous quality management can evaluaterepparttar 115174 effectiveness ofrepparttar 115175 changes and identify any additional needed areas of improvement. The outpatient preadmission process should be flow charted to facilitate a smooth patient transition throughrepparttar 115176 appointment schedule. This isrepparttar 115177 patient’s introduction to your heart program and efforts should be directed at providingrepparttar 115178 patient with a good first impression. The following issues should be addresses inrepparttar 115179 planning sessions forrepparttar 115180 preadmission appointment: •What time of day is best to schedule preadmission appointments •Where shouldrepparttar 115181 patient report •Who will educaterepparttar 115182 patient on post operative care, incentive spirometer, skin prep, family waiting, and discharge needs •Who will be involved inrepparttar 115183 preadmission process Due torepparttar 115184 need for a number of tests and significant clinical education it is recommended to schedulerepparttar 115185 preadmission appointment prior torepparttar 115186 day of surgery. This providesrepparttar 115187 time to reviewrepparttar 115188 test results and provide comprehensive education forrepparttar 115189 patient. The preadmission process can be accommodated in a same day surgical appointment but more opportunities are present for process delays. Frequently included withrepparttar 115190 diagnostic testing are a listing of consults for anesthesia and other services, an insurance assessment, and completion of history and physical by a physician assistant /certified nurse practitioner if this has not been provided by physician office. A standardized patient education session is a major component to patient surgical preparation. One ofrepparttar 115191 first steps should be to determine who will be involved inrepparttar 115192 education process. Cardiac care coordinator, clinical nurse specialist, or cardiovascular unit staff nurses are good choices to providerepparttar 115193 postoperative education. When multiple patient care providers are providing patient education it is recommended to scriptrepparttar 115194 education ensuring all topics are consistently presented. Many hospital heart programs are now offering preoperative cardiovascular patient education online through their website. This is another educational opportunity that complimentsrepparttar 115195 individualized approach. The patient education session should be brief as to not frightenrepparttar 115196 patient, but should reviewrepparttar 115197 major care components such as monitoring, invasive lines, tubes, and alarms. Most patients are interested in knowing whenrepparttar 115198 lines and tubes are inserted and how long they remain. Ambulation protocol should be explained so they can anticipate getting out of bed shortly after they awake from surgery. Skin prep and other medications such as Bactroban (if they are a part ofrepparttar 115199 night before prep) should be provided with written instructions and explanation for use. The educational session is also a good time to review specific discharge issues likerepparttar 115200 expected length of stay and need for someone to stay with themrepparttar 115201 first few days following discharge. A tour ofrepparttar 115202 post op recovery unit allowsrepparttar 115203 patient and their family to visualizerepparttar 115204 high level of care that will be provided. The committee should plan for howrepparttar 115205 sequence of appointments will flow to reduce wait times forrepparttar 115206 patients and all disciplines involved. This attention given to improvingrepparttar 115207 preadmission process can increaserepparttar 115208 level of confidencerepparttar 115209 patient and family has in your program. It starts their surgical experience off on a favorable note.

Why You Absolutely MUST Keep A Food Diary Or FAIL!

Written by Tony Tass


When starting a fat loss and/or fitness program, most people neglect one very important step......

......keeping track of what you eat.

Keeping a Food Diary, a meal by meal record of everything you eat, can often times meanrepparttar difference between success and failure on a fitness program.

You absolutely MUST, MUST, MUST keep a food diary if you are to succeed in losing weight. I cannot stress that enough!

Most people have NO CLUE what they are eating or even how much.

Most people guess as to what they're eating andrepparttar 115157 vast majority ofrepparttar 115158 time, they're WAY OFF!

Unless you write down EVERYTHING YOU EAT in a food diary, you will NEVER, EVER be able to accurately and consistently plan your weight loss. Don't fool yourself.

And you WILL FAIL....

It's a fact.

I did not get a handle on losing weight UNTIL I finally started to log everything I ate in a food diary on a meal-to-meal and day-to-day basis.

This does not have to be difficult. You can do it manually or use software for it. You can use a simple binder to keep track or even use your Palm Pilot.

I also recommend you buyrepparttar 115159 book "The Complete Book of Calorie Counts" by Corrine Netzer. It's one ofrepparttar 115160 best I've found that tells you exactly what's inrepparttar 115161 food you eat, even ethnic foods.

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