the role of nurse-led post-operative cardiac clinics: a fifteen month experience in wales
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The Role of Nurse-led Post-Operative Cardiac Clinics: A Fifteen Month Experience in Wales. Sister Ann Parkes, Mr Dheeraj Mehta and Miss Melanie Jenkins. Cardiff & Vale UHB. Standard Routine Follow-up Practice:. - PowerPoint PPT PresentationTRANSCRIPT
The Role of Nurse-led Post-Operative Cardiac Clinics:
A Fifteen Month Experience in Wales
Sister Ann Parkes, Mr Dheeraj Mehta and Miss Melanie Jenkins
Cardiff & Vale UHB
Standard Routine Follow-up Practice:
All CABG follow up patients were seen in the Consultant clinic 6 – 12 weeks post-op.
Main pressures on clinics = reduction in junior doctors working
hours
QUESTION: Could specific post-op patients be seen by experienced nurses, instead of a doctor?
Pilot Study Criteria for inclusion in the clinic Patients who had undergone CABG only
Clear objectives: To have a follow up appointment within 6-8 weeks of discharge,
To discharge patient back to referring cardiologistTo optimise secondary prevention medicationTo optimise risk factor modification
To free up medical manpower
Structured proforma / supervision Clinical support available
Post-operative Complications Prior to Clinic Visit
Post-op complications38%
Readmitted12%
No issues50%
N = 183
N = 17
Postoperative Complications at Clinic Visit
0
10
20
30
40
50
60
70
80
90
No of patients 87 15 11 37 3
No Issues Wound issues Arrythmias oedema Pleural effusions
47.5%
34% 6%
20%
1.6%
N = 183
Medication Changes initiated from Clinic Visit
No Changes42%
heart Failure/anti-hypertensives
37%
Anti-arrythmic5%
Anti-platelet8%
Diuretics8%
Referrals made following clinic visit
0
2
4
6
8
10
12
patients 3 7 3 5 5 1 5 12 6
Admitted via clinic
Cons Surgeon
EPSSmoking cessation
DieticianDiabetic Nurse
Cardiac Rehab
Cardiol clinic
ED Clinic
N = 183
Discharges
Discharged95%
Follow-up Cons Clinic5%
Nurse led follow up clinic post CABG
Provides challenges It is as safe and effective as that of a medic run
clinic. Supportive environment & training vital It is cost effective as it frees up medical man-
power. Complications are clearly highlighted and
managed with the full support of the surgical team as necessary.
The Way Forward:
PCI Cardiology clinic
Future plans are to develop a clinic for post-operative valve surgery
To provide training for recent newly appointed nurse practitioners to assist and cover in the clinics
Thank you.
Any Questions?
