Quality Improvement Project of Nurse Guiding Incentive Spirometry After Cardiac Surgery

NCT06041295 | Unknown

• 1 other identifier: 202308062RINB
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

Studies have shown that patients undergoing general anesthesia surgery are prone to pulmonary complications after surgery; about 30-72% of cardiac surgery patients have postoperative chest X-rays that reveal lung collapse, leading to gas exchange disorders and hypoxemia. Postoperative lung expansion therapy can increase ventilation-perfusion balance, increase lung volume, promote respiratory mucosal sputum production and reduce postoperative pain, and has been proven to improve postoperative pulmonary-related complications. Inducement spirometry is currently one of the mainstream methods of performing lung expansion treatment. It uses visual feedback to allow the patient to perform slow, deep breathing with sufficient airflow or volume to achieve the lung expansion effect; it is also used after cardiac surgery in our hospital. The main way for patients to perform lung expansion therapy; compared with only performing respiratory exercises after surgery, induced spirometry can reduce the incidence of lung collapse and respiratory distress in postoperative patients, and can also shorten the ICU stay and total hospitalization stay. Most cardiac surgery patients in our hospital are given health education on lung expansion therapy by nursing staff before and after surgery. This unit does not have specialized courses on lung expansion therapy, which may lead to differences in explanations between different nursing staff; some patients' lack of knowledge and understanding of lung expansion treatment resulted in the treatment effect not being as good as expected, which motivated the author to formulate a project for improvement. We hope to analyze, review and improve the current situation to improve the effectiveness of lung expansion treatment for patients. Based on the current situation analysis and relevant literature, a project to improve nursing guidance for lung expansion therapy was implemented.

Conditions

Lung Expansion Therapy; Post-cardiac Surgery

Outcome Measures

Primary Outcomes (2)

• The improvement of nursing staff's awareness rate of lung expansion therapy

  The improvement before and after on-the-job training

  week 2 after on-the-job training

• The improvement of nursing staff's correct rate of education of lung expansion therapy

  The improvement before and after on-the-job training

  week 2 after on-the-job training

Secondary Outcomes (3)

• The improvement of patients' correct rate of lung expansion therapy

  week 2 after nurse staff's on-the-job training

• The improvement of respiratory complication rate

  week 2 after nurse staff's on-the-job training

• Nurses' satisfaction of the quality improvement project survey

  week 2 after nurse staff's on-the-job training

Study Arms (1)

the cardiovascular surgery ICU nurse staff

EXPERIMENTAL

on-the-job training of lung expansion therapy

Behavioral: on-the-job training of lung expansion therapy

Interventions

on-the-job training of lung expansion therapy BEHAVIORAL

on-the-job training of lung expansion therapy

the cardiovascular surgery ICU nurse staff

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Nurse staff in cardiovascular surgery ICU of National Taiwan University Hospital

You may not qualify if:

• None
• Patients:
• years of age and above
• Perform cardiovascular surgeries at National Taiwan University Hospital
• After surgery, the endotracheal tube is inserted and admitted to the cardiovascular surgery intensive care unit, and the endotracheal tube is removed in the intensive care unit.
• There is a clinical indication to perform lung expansion therapy
• Clear consciousness and able to cooperate with instructions
• Hemodynamic instability (mean arterial pressure remains below 60 mmHg after infusion or vasopressor administration)
• Severe lung diseases (such as uncontrollable asthma, severe pulmonary obstruction, untreated pneumothorax, etc.)
• Unable to perform effective deep breathing (for example: vital capacity is less than 10 ml/kg or inspiratory capacity is less than 1/3 of the predicted value)

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Central Study Contacts

Yi-Ting Hung, Bachelor

CONTACT

+886-910720142; birdymkii@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 11, 2023
• First Posted: September 18, 2023
• Study Start: September 6, 2023
• Primary Completion: December 31, 2023
• Study Completion: January 31, 2024
• Last Updated: September 18, 2023

Record last verified: 2023-09

Data Sharing

• IPD Sharing: Will not share