Nursing Theory, Terminology, and Big Data: Data-Driven Discovery of Novel Patterns in Archival Randomized Clinical Trial Data.

Background: The growth and diversification of nursing theory, nursing terminology, and nursing data enable a convergence of theory- and data-driven discovery in the era of big data research. Existing datasets can be viewed through theoretical and terminology perspectives using visualization techniques in order to reveal new patterns and generate hypotheses. The Omaha System is a standardized terminology and metamodel that makes explicit the theoretical perspective of the nursing discipline and enables terminology-theory testing research.

Patient outcomes after transcatheter and surgical pulmonary valve replacement for pulmonary regurgitation in patients with repaired tetralogy of Fallot: A quasi-meta-analysis.

Background: Individuals with repaired tetralogy of Fallot develop pulmonary regurgitation that may cause symptoms (dyspnea, chest pain, palpitations, fatigue, presyncope, and syncope), impair functional capacity, and may affect health-related quality of life. Surgical pulmonary valve replacement is the gold standard of treatment although transcatheter pulmonary valve replacement is becoming more common. Patients want to know whether less invasive options are as good.

The effectiveness of and satisfaction with high-fidelity simulation to teach cardiac surgical resuscitation skills to nurses.

Background: There are few reports of the effectiveness or satisfaction with simulation to learn cardiac surgical resuscitation skills.

Objectives: To test the effect of simulation on the self-confidence of nurses to perform cardiac surgical resuscitation simulation and nurses' satisfaction with the simulation experience.

Methods: A convenience sample of sixty nurses rated their self-confidence to perform cardiac surgical resuscitation skills before and after two simulations.

Transcatheter Closure of Patent Ductus Arteriosus in Extremely Premature Newborns: Early Results and Midterm Follow-Up.

Objectives: The goal of this study was to describe early and midterm outcomes of extremely premature newborns (EPNs) who underwent transcatheter echocardiographically guided patent ductus arteriosus (PDA) closure.

Background: Surgical ligation of PDA in EPNs confers significant risk for procedural morbidity and adverse long-term outcomes.

Methods: The Amplatzer Vascular Plug II was used in all cases.

Team-Based Learning Improves Staff Nurses' Knowledge of Open- and Closed-Chest Cardiac Surgical Resuscitation.

Background: There are few reports of the use of 1-session team-based learning (TBL) in hospital settings and none to teach cardiac surgical resuscitation (CSR).

Objective: The aim of this study was to investigate whether 1-session TBL is an effective method to increase nursing knowledge of CSR.

Methods: The participating subjects viewed a PowerPoint presentation about CSR prior to the learning session.

Your Patient Has Congenital Heart Disease--What Questions Should You Ask to Provide High-Quality Care?

Congenital heart disease (CHD) is the most common birth defect. About two-thirds of those individuals living with CHD are now adults. If you do not have in-depth knowledge of CHD, knowing what questions to ask and what resources to use can improve patient outcomes and satisfaction with care.

CE: Long-term outcomes after repair of congenital heart defects: part 2.

Many congenital heart defects can be repaired, but long-term monitoring is often required to forestall possible complications. This two-part article reviews 10 common congenital heart defects, their repairs, and their common long-term outcomes, along with the implications for nurses in cardiac and noncardiac settings alike. Here, in part 2, the author reviews four defects: tetralogy of Fallot, transposition of the great arteries, congenitally corrected transposition of the great arteries, and single-ventricle defects.

CE: Long-term outcomes after repair of congenital heart defects: part 1.

Many congenital heart defects can be repaired, but long-term monitoring is often required to forestall possible complications. This two-part article reviews 10 common congenital heart defects, their repairs, and their common long-term outcomes, along with the implications for nurses in both cardiac and noncardiac settings. Here, in part 1, the author reviews six defects: bicuspid aortic valve, atrial septal defect, ventricular septal defect, atrioventricular septal defect, coarctation of the aorta, and pulmonic stenosis.

Long-term issues after the Fontan procedure.

The Fontan procedure is used to treat various serious congenital heart defects. Although many people who have had the procedure live productively into adulthood, as they age, they face several health issues due to the physiology of the Fontan circulation. This article reviews the 4 types of Fontan procedures and the changes caused by the surgery, including single-ventricle physiology, nonpulsatile pulmonary perfusion, systemic venous hypertension, and intracardiac scarring, as well as their sequelae.

Transcatheter aortic valve implantation outcomes: implications for practice.

Aortic stenosis is a common valvular pathological finding in older adults. Currently, aortic valve replacement is the gold-standard treatment for severe symptomatic aortic stenosis. However, patients with advanced age and multiple comorbidities carry a significant operative risk.

Delirium in older cardiac surgery patients: directions for practice.

Delirium affects approximately 20% to 25% of patients undergoing cardiac surgery and is particularly common in older adults. This article reviews the etiology and risk factors for delirium associated with cardiac surgery in older adults. Delirium screening, prevention, and treatment strategies, including both pharmacological and nonpharmacological therapies, are presented.

Using audience response technology in hospital education programs.

An audience response system (ARS) is an interactive teaching tool that permits an instructor to poll an audience, either anonymously or in a tracked manner, in response to questions. The instructor can then display the responses to the audience. An ARS can be used in hospital-based education programs to assess group learning.

Cardiac surgical nurses' use of atrial electrograms to improve diagnosis of arrhythmia.

Background: The practice standard for electrocardiographic monitoring in hospitals recommends use of atrial electrograms after cardiac surgery to help diagnose cardiac arrhythmias.

Objectives: To determine whether use of atrial electrograms significantly improves nurses' ability to diagnose cardiac arrhythmias and to assess nurses' perceptions of the ease of obtaining and interpreting electrograms, the frequency of use of atrial electrograms, and the correlation between nurses' experience with the technique and arrhythmia scores.

Methods: In total, 282 nurses completed a test consisting of 5 electrocardiographic rhythms for which use of atrial electrograms might improve interpretation.

Cardiac support devices.

Heart failure is an increasingly common condition in the United States and is associated with high mortality and burden to health care. It is a chronic condition that is characterized by progressive left ventricular enlargement. While medical therapy can slow the progression of left ventricular remodeling, surgical approaches to treatment have been developed to improve the survival and quality of life of heart failure patients.

Transcatheter and transapical aortic valve replacement.

Minimally invasive valve replacement is limited to bioprosthetic aortic and pulmonary valves for use in very specific populations of patients. Replacement via trans-catheter and transapical techniques should be used only in patients in whom traditional surgical replacement is deemed an unacceptable risk. Nursing management will focus heavily on care for comorbid conditions because of the high-risk nature of the patients in whom these valves will initially be implanted.

ECG monitoring after cardiac surgery: postoperative atrial fibrillation and the atrial electrogram.

Atrial fibrillation is one of the most common complications after cardiac surgery and is associated with adverse outcomes such as increased mortality, neurological problems, longer hospitalizations, and increased cost of care. Major risk factors for the development of postoperative atrial fibrillation include older age and a history of atrial fibrillation. beta-Blockers are the most effective preventive therapy, although sotalol and amiodarone can also be used for prophylaxis.

Myectomy for hypertrophic obstructive cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiovascular death in young people. Myectomy is the gold standard treatment for hypertrophic obstructive cardiomyopathy (HOCM). This article briefly reviews the pathophysiology and medical management of HOCM.

Repaired tetralogy of Fallot in the adult.

The majority of persons living with tetralogy of Fallot are now adults and may face a number of long-term cardiac problems that necessitate reoperation. These problems include pulmonary regurgitation, tricuspid regurgitation, ventricular tachycardia, atrial flutter and/or fibrillation, pulmonary artery branch stenoses, right ventricular aneurysms, right ventricular outflow tract obstruction, residual ventricular septal defects, and coronary artery disease. Management approaches to these potential problems are discussed.