Postoperative Comfort Measures for Coronary Artery Bypass Graft Patients

 
 
 
 
The average life expectancy of Americans is 76.4 years, but almost 62 million Americans have one or more types of cardiovascular disease (Barnett & Halpin, 2003). Among the more common surgical procedures performed among Americans with cardiovascular disease is the coronary artery bypass grant (CABG), at a rate of almost 600,000 such surgeries taking place annually and an expected 7 to 8 percent annual increase in the number of CABGs (Barnett & Halpin, 2003). Consequently, identifying the most effective postoperative comfort measures that can be implemented by nurses is an issue of significance that speaks directly to the strong focus in nursing of providing patients with interventions and services that maximize recovery, improve quality outcomes, and enhance well-being. The focus of this report is on a qualitative review of professional literature depicting and evaluating various nursing measures that increase patient comfort after a CABG.

The scope of the research is limited specifically to studies identifying nursing interventions that improve the physical and psychological comfort of postoperative CABG patients. The study does not address the benefits of the procedure, its short- and long-term impact upon health status and cardiovascular functioning, or nursing interventions that are not directly focused on improving postoperative comfort levels.

Several themes emerge in the literature regarding nursing care and interventions that enhance the


     
 
 
 
    

 

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tion, and behavioral therapies. Holistic nursing efforts, as described by the author, move beyond the limitations of the Western pharmaceutical intervention typology and include alternative herbal pain control products as well as strategies for reducing attention to pain. While interesting, the probability that biofeedback and/or meditation would be sufficiently mastered by a patient having experienced CABG is somewhat limited. To be successful, these interventions should be delivered and mastered prior to surgery. Brennan, Bjornsdottir, Jones, Viscovsky, and Rogers (2001) described HeartCare, an Internet-based information and support system for patients recovering at home from CABG. Using the Internet, patients can access nursing information regarding pain management and other issues arising at home after surgery; nurses can directly respond, through an interactive Web site, to patient questions and concerns. Specific, individualized care plans and instruction can be provided. While useful, such a system depends upon the ability of patients to access the Web site, the degree to which the site provides for a timely response to queries, and patients' capacity for following nursing instructions. Barnett and Halpin (2003) ass

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