The Effect Of Fast Track Care On Length Of Stay Patients Undergoing Cardiac Surgery

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Running Head: FAST TRACK CARE Review of Literature The Effect of Fast Track Care on Length of Stay in Patients Undergoing Cardiac Surgery Alisa Ruffner, BSN Fall 2014 University of Tennessee Health Science Center: College of Nursing NSG 819: Evaluation of Practice Introduction Cardiac surgery is among the most frequently performed surgical procedures in the United States. According to the American Heart Association, over 575,000 open heart surgeries were performed in 2005. Until relatively recently, sedation and prolonged ventilatory support through the first twelve to eighteen hours post operatively have been standard. This allowed adequate time for the patient’s hemodynamic, respiratory and coagulation physiological…show more content…
How does fast track care compare to conventional care after cardiac surgery? Methods An electronic review of literature was conducted through PubMed, Clinicalkey, and MEDLINE OVID databases. Key words and phrases searched included ‘fast track’, ‘cardiac surgery’, ‘length of stay’, ‘intensive care unit’, and ‘protocols’. The evidence in the articles were evaluated and examined in the attached table. The evidence was also categorized for quality using the Grade model rating from A to D. Findings The most significant publication found involving fast track care was a Cochrane review entitled “Fast-track cardiac care for adult cardiac surgical patients”. This review examined 25 trials and included over 4,000 patients. The trails included in this review were randomized control trials “that compared the use of low-dose opioid based general anesthesia versus high-dose opioid based general anesthesia, and early extubation using time-directed protocols versus usual care for extubation” (Zhu, Lee, & Chee, 2012). This review examined several outcomes including mortality, post-operative complications, time to extubation, ICU length of stay, hospital length of stay, and inpatient costs. The authors concluded, based on these studies, that fast track care was safe for patients undergoing low to moderate risk cardiac surgery. The combination of low dose opioid anesthesia combined with a rapid extubation protocol post operatively is shown to decrease the time on

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