Cardiac Surgery Manual for Nurses: Orientation, Policy, and Procedures

AORN Journal,  March, 2008  by Rebecca J. Davis

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Cardiac Surgery Manual for Nurses: Orientation, Policy, and Procedures

Debi Stephens-Lesser

2007, 406 pages

$48.95 softcover

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This comprehensive book establishes a framework for perioperative standards of care of the cardiac surgery patient. These multidimensional standards address

* scheduling,

* staffing,

* preoperative and intraoperative preparation and care,

* risk management,

* education,

* case management, and

* special cardiac procedures.

The cardiac nurse who is competent in these standards is able to adjust to rapid changes in patient volume, case mix, human and material resource availability, and procedure variability.

Nurses who choose to specialize in cardiac surgery must have a basic understanding of the team composition and the functioning of the team as individual members and as team members, and they also must understand the expectations team members have of one another. The author addresses the composition of a team and the general standard of care for the cardiac surgery team.

This book provides a good overview of the critical thinking that is necessary to develop a new program or enhance an existing program. The book thoroughly addresses the types of surgical procedures and functions that a nurse encounters as a member of the cardiothoracic specialty and also provides an outcomes-based approach to care and process improvement.

There are 10 chapters in the book, and the author starts with a basic description of the components and educational needs of a cardiac surgery program. The author also provides details of preoperative preparation and patient-care activities. Topics such as general intraoperative management easily transition into topics covering special procedures and end with elements of patient safety and risk management. Each topic is addressed using an appropriate policy, procedure, and standard of care. The author provides a complete learning activity for each surgical procedure and patient event and for the use of specialized equipment that a nurse may encounter during the performance of his or her role.

For example, the section that covers cardiopulmonary bypass begins with a policy that identifies specific parameters and requirements for initiating bypass. The text then provides a detailed explanation of cardiopulmonary bypass and how it works, including all aspects of the process. The next section outlines a procedure for the bypass process and identifies a quality outcome. Included are specific steps and rationales along with important safety tips for working around the bypass machine. The final section discusses the standard of care and addresses the phases of the bypass procedure, required equipment, and any special considerations. A review of the entire bypass procedure includes steps for inserting perfusion catheters, connecting the catheters to the perfusion tubing, and initiating bypass or cardiopulmonary perfusion, as well as important patient responses during and after this procedure.

This is an excellent text for the new or experienced cardiac surgery nurse. Nurses often learn from one another and also gain experience as new techniques and technologies emerge and are incorporated into this surgical specialty. Nurses do not always have the opportunity to enhance their knowledge of the anatomy, physiology, and physiologic responses of the cardiac surgery patient. This book provides this type of information, which can help build a good foundation of knowledge. The reader may sense the authors opinions throughout the text; however, the theories and models presented provide a good framework from which to operate. This book is an excellent resource for training and orienting new nurses, and it may improve the quality of care given to patients by members of the established team.

This book is available from Jones and Bartlett Publishers, 40 Tall Pine Drive, Sadbury, MA, 01776.

REBECCA J. DAVIS

RN, MN, CNOR

PATIENT SAFETY OFFICER

ACCREDITATION/PERFORMANCE SPECIALIST

QUALITY MANAGEMENT

GOOD SAMARITAN HOSPITAL

PUYALLUP, WA

COPYRIGHT 2008 Association of Operating Room Nurses, Inc.
COPYRIGHT 2008 Gale, Cengage Learning