Myra Cook1, Laura Idzior2, James F Bena3, Nancy M Albert4. 1. Cleveland Clinic Health System, Office of Nursing Education and Professional Development, 9500 Euclid Avenue, Mail Code HSB-111, Cleveland, OH 44195, United States. Electronic address: cookm3@ccf.org. 2. Cleveland Clinic Main Campus, Nursing Institute, 9500 Euclid Avenue, Mail Code J5-611, Cleveland, OH 44195, United States. Electronic address: idziorl@ccf.org. 3. Cleveland Clinic Health System, Quantitative Health Sciences, 9500 Euclid Avenue, Mail Code JJN3-294, Cleveland, OH 44195, United States. Electronic address: benaj@ccf.org. 4. Cleveland Clinic Health System, Office of Nursing Research and Innovation, 9500 Euclid Avenue, Mail Code J3-4, Cleveland, OH 44195, United States. Electronic address: albertn@ccf.org.
Abstract
PURPOSE: Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. DESIGN: Prospective, descriptive. METHODS: Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate. RESULTS: Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size <28 French, and when both mediastinal and pleural tubes were present (all p<0.001). In the first 4-hours, time spent on chest tubes was higher when patients had previous cardiac surgeries (p≤0.002), heart failure (p<0.001), preoperative anticoagulant medications (p=0.031) and reoperation for postoperative bleeding/tamponade (p=0.005). CONCLUSIONS: Time to manage chest tubes can be anticipated by patient characteristics. Nurse comfort with chest tube-related tasks affected time spent on chest tube management. Published by Elsevier Ltd.
PURPOSE: Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. DESIGN: Prospective, descriptive. METHODS: Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate. RESULTS: Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size <28 French, and when both mediastinal and pleural tubes were present (all p<0.001). In the first 4-hours, time spent on chest tubes was higher when patients had previous cardiac surgeries (p≤0.002), heart failure (p<0.001), preoperative anticoagulant medications (p=0.031) and reoperation for postoperative bleeding/tamponade (p=0.005). CONCLUSIONS: Time to manage chest tubes can be anticipated by patient characteristics. Nurse comfort with chest tube-related tasks affected time spent on chest tube management. Published by Elsevier Ltd.
Authors: Shinji Okano; Mark Lobosky; Raymond Dessoffy; David J Horvath; Kiyotaka Fukamachi; Jamshid H Karimov Journal: Artif Organs Date: 2020-07-05 Impact factor: 3.094