Use of nasal cannula versus face mask after extubation in patients after cardiothoracic surgery.

Continuous reevaluation of protocols for patients' care is necessary to maintain high quality and cost-effectiveness in today's healthcare environment. A study of patients who had cardiothoracic surgery proved that after early extubation, patients could safely be given oxygen via nasal cannula with maintenance of acceptable oxygen saturation. The positive outcomes of this study were shorter exposure to oxygen at higher concentrations, greater compliance by patients, greater comfort for patients, and cost savings for the institution.

Using clinical pathways in patients undergoing cardiac valve surgery.

Clinical pathways, protocols, and standing order sets help organize patients' care and eliminate variations created by practitioners' different preferences. Much attention is being focused on providing the most cost-effective care in the shortest time. Quality of care must be maintained during this process.

Improving the care of cardiothoracic surgery patients through advanced nursing skills.

All the nurses in the cardiothoracic ICU are now certified in these advanced skills. The skills are reviewed with current staff members on a yearly basis during the annual evaluation. During their orientation to the cardiothoracic ICU, new staff nurses are certified by using the original process of attending an in-service training program and demonstrating the skill 3 times.

Clinical pathways and coronary artery bypass surgery.

Use of a multidisciplinary clinical pathway helps eliminate variations in patients' care. Organizing the care delivered each day of the patient's hospitalization may lead to fewer complications, a quicker recovery, and an earlier discharge. In today's healthcare arena, much attention is being focused on improving the quality of care and decreasing the need for acute care.

Comparison of heparinized and nonheparinized solutions for maintaining patency of arterial and pulmonary artery catheters.

Background: Arterial and pulmonary artery catheters are often used in the management of critically ill patients. If heparin were not necessary to maintain the patency of arterial and pulmonary artery catheters, these patients could avoid exposure to heparin.

Objectives: The purpose of this study was to determine if the failure rate of arterial and pulmonary artery catheters differs depending on whether a nonheparinized or heparinized solution is used.