Aortic Stenosis Is Recognised As The Most Prevalent Form Of Valvular Heart Disease

Many healthcare leaders are advocates for, and believe that patient engagement and experience has gained true importance and value in improving healthcare quality, it has easily become the ‘heart’ of the core definition of ‘quality care’. It is clear that patients are able to provide expertise beyond generic feedback on ways of improving the patient experience.

With the development of the nurses understanding, the nurse will be able to clearly communication across relevant information. This will promote patient participation (Tobiano, Marshall, Bucknall, & Chaboyer, 2016) and empower the patients voice by actively involving them in the decision-making process. Per the Health and Disability Act (1994, as cited in Medical Council of New Zealand, n.d) patients should have their treatment explained to them, including the benefits, risks, alternatives and costs; as well as having the option to change their mind at any time. This all contributes to the development of a partnership and ensures that the patient will cooperate with tasks at hand. However, the lack of communication with the patient regarding their treatment can cause severe anxiety and ultimately a breakdown in the trust between the patient and the nurse. The successful implementation of this in practice can be seen in an observational study conducted by Tobiano et al. (2016).

The process of consent should apply not only to surgical procedures but all clinical procedures and examinations which involve any form of touching. This must not mean more forms: it means more communication. As part of the process of obtaining consent, except when they have indicated otherwise, patients should be given sufficient information about what is to take place, the risks, uncertainties, and possible negative consequences of the proposed treatment, about any alternatives and about the likely outcome, to enable them to make a choice about how to proceed.”5

This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has

It was established that the patient’s symptoms were due to an aortic regurgitation this was confirmed by echocardiogram. The use of the SOAPIER model is an effective means of providing rationale for a holistic clinical decision making. The findings and treatment options were discussed in a multidisciplinary meeting including Mr Jones and family. The family were informed that surgery was the safest treatment option. Complications that could happen with or without surgery were also explained ensuring that the patient had adequate understanding to make a valid choice about his treatment. Mr Jones agreed that a replacement of the aortic valve with a mechanical valve was necessary, thus it last for more than twenty years or more . Mr Jones

heart. The old valve is pushed to the side and the new valve gets implanted. This procedure

A doctor may also suggest treatment later in a person’s life, if the disease worsens. If a cardiologist suggests medical treatment, two options include: Mitral Valve Repair or Mitral Valve Replacement. “If the patient chooses to have Mitral Valve Replacement, he or she should find a surgeon who satisfies three criteria; the surgeon should have a 90 percent or greater rate of successful repair, should have an extremely low rate of death from surgery (less than 1 percent) and should be proficient in operating with less invasive approaches, if your surgeon cannot provide these sorts of numbers, you need to move to another” (Gillinov 326). By reconnecting valve leaflets a surgeon can perform Mitral Valve Repair (mayoclinic.org). A surgeon can also remove excess tissue from the valve for a repair (mayoclinic.org). “The traditional approach to most aortic valve problems is to open the chest, remove the old valve, and sew in a new one” (Gillinov

This past Friday in the cardiac catheterization lab I began my day with continuing the work that I was previously assigned to do last week where I collected the data of patient's Cardiothoracic surgery. I continued to familiarize myself with the different types of Cardiothoracic surgery procedures, however, the specific reports I was working with, they are called TAVR report (Transcatheter Aortic Valve Replacement). I later learned and was explained to, the TAVR multiple procedures and its causes, which is aortic stenosis. As for the procedures, a valve needs to be placed in the heart and each procedure delivers it a different way. The three ways the valve can be placed in the heart is through the heart's femoral artery (the transfemoral approach),

Shared decision making should involve both health professionals and patients in discussions about their care. “While health professionals hold the expert clinical and technical knowledge, patients are experts about their own lives and treatment objectives, and also what is important to them when making decisions. (Lally, Macphail, Palmer, Blair and Thomsom, 2011).

In addition, throughout any procedure, the nurse should continue to educate and maintain strong communication with the patient to avoid any surprises that may upset them. This includes thoroughly explaining why, how, and what the nurse will be doing.

There were no early or late postoperative deaths and we achieved 100% follow-up for included patients. No patient had aortic valve replacement after one year. Preoperatively the mean ejection fraction in group S was 62.33±4.39% while in group R was 59.53±6.10%, the width of the regurgitant jet in group S was 34.67±2.72 % and in the group, R was 35.73±1.87 % ( p-value non-significant). Postoperatively after 1 year follow up the width of the regurgitant jet in group S increased significantly to 37.27±4.67% ( p > 0.5) while in group S almost remained unchanged 34.73±4.13% ( p <

For many patients, surgery is performed on the damaged valves. Surgery types differ for each individual depending upon which valves were affected, how severely they were infected, and if valves had previously been replaced artificially. Before surgery, patients must undergo a series of strenuous tests and careful assessments to be sure he or she qualifies for surgery. In a particular study, several patients were able to undergo valve replacement surgery.

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional

Gilmartin, J. (2003). Day surgery: Patients’ perceptions of a nurse-led preadmission clinic. Journal of Clinical Nursing 13, 243-250.

The ACC/AHA guidelines on valvular heart disease 2014 classified all VHD including MR into four stages-A(at risk),B(progressive),C(asymptomatic severe) and D(symptomatic severe).Stage C is again divided into C1-compensated and C2 –decompensated.The frequency of echocardiography for asymptomatic patients with normal LV function is outlined.Stage B patients of MR should undergo echo every 3 to 5 years if mild and 1-2 years if moderate severity.In Stage C patients,the recommended frequency is 6-12 months except in a dilating LV when it should be done more frequently.20