Journal List > J Korean Acad Nurs Adm > v.21(3) > 1051799

Uhm and Lee: Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit

Abstract

Purpose

The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU).

Methods

Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS.

Results

The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (χ2=7.23, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (χ2=6.66, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (χ2=20.31, p<.001).

Conclusion

Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

Figures and Tables

Figure 1

Postoperative handover sheet (A) and daily goal sheet (B) (final version).

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Table 1

Characteristics (N=372)

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PCS=Practical communication strategies, RACHS=Risk adjustment classification for congenital heart surgery method, CPB=Cardiopulmonary bypass, ICU=intensive care unit, LOS=Length of stay.

Table 2

Comparison of Major (N=372)

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PCS=Practical communication strategies; RACHS=Risk adjustment classification for congenital heart surgery method; ICU=Intensive care unit; LOS=Length of stay; CPR=Cardiopulmonary resuscitation; ECMO=Extracorporeal membranous oxygenation; AEs=Adverse events; NA=Not applicable.

Table 3

Analysis of Minor Adverse Events (N=83)

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PCS=Practical communication strategies; CT=Chest tube; AEs=Adverse events.

Table 4

Comparison of Communication Satisfaction (N=15)

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PCS=Practical communication strategies; CNS=Clinical nurse specialist.

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