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Original Article

Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit

Ju-Yeon Uhm1, Worlsook Lee2
Journal of Korean Academy of Nursing Administration 2015;21(3):243-253.
Published online: June 30, 2015

1Department of Nursing, Asan Medical Center, Korea.

2Department of New Health Technology Assessment, National Evidence-based Healthcare Collaborating Agency, Korea.

Correspondence: Lee, Worlsook. National Evidence-based Healthcare Collaborating Agency, 173 Toegye-ro, Jung-gu, Seoul 100-705, Korea. Tel: +82-2-2174-2746, Fax: +82-2-741-7060, moonlee@neca.re.kr
• Received: January 14, 2015   • Revised: April 7, 2015   • Accepted: May 12, 2015

Copyright © 2015 Korean Academy of Nursing Administration

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • 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.
  • Key Words: Heart defects, Congenital; Intensive Care Units; Patient handoff; Outcome Assessment (Health Care)
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Figure 1

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

jkana-21-243-g001.jpg
Table 1

Characteristics (N=372)

jkana-21-243-i001.jpg

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)

jkana-21-243-i002.jpg

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)

jkana-21-243-i003.jpg

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

Table 4

Comparison of Communication Satisfaction (N=15)

jkana-21-243-i004.jpg

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

Figure & Data

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      Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit
      J Korean Acad Nurs Adm. 2015;21(3):243-253.   Published online June 30, 2015
      DOI: https://doi.org/10.11111/jkana.2015.21.3.243
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      Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit
      J Korean Acad Nurs Adm. 2015;21(3):243-253.   Published online June 30, 2015
      DOI: https://doi.org/10.11111/jkana.2015.21.3.243
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      Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit
      Image
      Figure 1 Postoperative handover sheet (A) and daily goal sheet (B) (final version).

      Figure 1

      Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit

      Characteristics (N=372)

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

      Comparison of Major (N=372)

      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.

      Analysis of Minor Adverse Events (N=83)

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

      Comparison of Communication Satisfaction (N=15)

      PCS=Practical communication strategies; CNS=Clinical nurse specialist.
      Table 1 Characteristics (N=372)

      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)

      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)

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

      Table 4 Comparison of Communication Satisfaction (N=15)

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

      Table 1

      Table 2

      Table 3

      Table 4

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