Article Abstract:
The cardiac surgery program at Baystate Medical Center, Springfield, MA, emphasizes the importance of planning for discharge. Before the operation, discharge arrangements are discussed. Early extubation and structured activity guidelines are parts of the program. The staff nurse, the mid-level practitioner (MLP) and the clinical resource coordinator are all important in facilitating the plan. Length of stay, and thus cost, has declined over two years and it is hoped that intensive care unit cost and overall cost of care will continue to decrease with the start-up of the progressive care unit and the early extubation.
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Article Abstract:
Minimally invasive cardiac surgery is on the horizon. Already 1500+ patients in the world have undergone minimally invasive direct coronary artery bypass (MIDCAB) surgery; correction of congenital defects; and valvular repair and replacement, to the mitral and aortic areas especially. Cardiac surgery is changing as advances are made in endoscopic and other instrumentation procedures such as video instrumentation, port access, and computer-assisted technology. MIDCAB surgery is bypass graft surgery through small ports of incision made in the chest wall between ribs without using cardiopulmonary bypass.
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Article Abstract:
Cardiac disease and heart surgery affect women substantially differently than men, yet research on gender differences in cardiac care is limited. Endogenous estrogens provide some protection against cardiac disease, so women typically develop symptoms later than men. Women frequently experience dyspnea or epigastric pain, rather than chest pain, during myocardial infarction. Women are less likely to undergo diagnostic cardiac catheterization or to participate in postoperative cardiac rehabilitation. Nurses can make important contributions to cardiac care plans for women.
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