Effect of Protocol of Care on Clinical Outcomes of Patients with Chest Tube Post Cardiothoracic Surgery

Abstract

Cardiothoracic surgery is a surgical specialty, which deals with the diagnosis and management of surgical conditions of the heart, lungs and esophagus ⁽¹⁾ .Chest tube (CT) is an invasive procedure which inserted post cardiothoracic surgery to facilitate lung expansion and allowing  the drainage of fluids from the chest cavity. Aim: this study aimed to evaluate the effect of protocol of care on clinical outcomes of patients with chest tube post cardiothoracic surgery. Materials and method a quasi-experimental research design was conducted at Cardiothoracic Surgery Department at Tanta University hospital. A purposive sample of 80 adult patients with chest tube based on statistical power analysis were selected and divided into two equal group 40 patients in each group as follows: Group 1: (Study group): consist of 40 adult patients were received protocol of care implemented by the researcher. Group 2: (Control group): consists of 40 adult patients who were received routine nursing care by hospital nursing staff. Three Tools were used to collect the data .Tool (I) Biosocio-demographic characteristics. Tool (II) Chest tube assessment, Tool (III) Pain assessment. Results:- The mean duration of ICU stay in control group (6.77) was higher than in the study group (4.97) days, more than half (52.6%)of the patients in the control group at the 7^th day of the study had elevated body temperature comparing to none  in the study group, nearly two third (62.5%) of patients has  a positive culture swab in the control group at the  7^th day of the study group ,compared to about  third(35%) of patients in the study group. More than half of patients (52.5%) in the control group had a severe pain during removal of chest tube compared to small percentage (5.0%) in the study group. Conclusions and recommendations:-Protocol of nursing care which was composed of deep breathing and coughing   exercises, sterile technique during chest tube dressing, and cold application, are recommended for all cardiothoracic surgical patients with chest tube.

Keywords: Protocol of Care, Clinical Outcomes, Cardiothorathic Surgery