Abstract
BackgroundCardiac surgery is becoming increasingly common in older, more vulnerable adults. A focus on timely and complete medical and functional recovery has led to the development of enhanced recovery protocols (ERPs) for a number of surgical procedures and subspecialties, including cardiac surgery (ERAS® Cardiac). An element that is often overlooked in the development and implementation of ERPs is the involvement of key stakeholder groups, including surgery patients and caregivers (e.g., family and/or friends). The aim of this study is to describe a protocol for a scoping review of cardiac patient and caregiver preferences and outcomes relevant to cardiac surgery ERPs.MethodsUsing Arksey and O’Malley’s et al six-stage framework for scoping review methodologies with adaptions from Levac et al. (Represent Interv: 1–18, 2012), a scoping review of existing literature describing patient- and caregiver-identified preferences and outcomes as they relate to care received in the perioperative period of cardiac surgery will be undertaken. The search for relevant articles will be conducted using electronic databases (i.e., the Cochrane Library, Medline, PsycINFO, Scopus, and Embase), as well as through a search of the grey literature (e.g., CPG Infobase, Heart and Stroke Foundation, ProQuest Theses and Dissertations, Google Advanced, and Prospero). Published and unpublished full-text articles written in English, published after the year 2000, and that relate to the research question will be included. Central to the design of this scoping review is our collaboration with two patient partners who possess lived experience as cardiac surgery patients.DiscussionThis review will identify strategies that can be integrated into ERPs for cardiac surgery which align with patient- and caregiver-defined values. Broadly, it is our goal to demonstrate the added value of patient engagement in research to aid in the success of system change processes.
Highlights
Enhanced recovery after cardiac surgery (Cardiac) surgery is becoming increasingly common in older, more vulnerable adults
The specific aims of this study are to present a protocol for a scoping review of patient and caregiver preferences and outcomes as they related to the perioperative period of cardiac surgery
A scoping review is more appropriate than other methods of literature review because the topic is broad, of a qualitative nature, and has not been extensively studied in this patient population
Summary
Cardiac surgery is becoming increasingly common in older, more vulnerable adults. A focus on timely and complete medical and functional recovery has led to the development of enhanced recovery protocols (ERPs) for a number of surgical procedures and subspecialties, including cardiac surgery (ERAS® Cardiac). Advances in perioperative care (i.e., care before, during, and after surgery) have contributed to ongoing reductions in mortality and complication rates following cardiac surgery in increasingly older, vulnerable adults [2,3,4]. While these “hard” outcomes are of significant value, it is becoming increasingly evident that attention needs to be given to enhancing recovery of patients after surgery through, for example, a focus on patient-centered outcomes (i.e., functional capacity and rehospitalization rates) and health-related quality of life [5]. Of the 20 current published ERP guidance documents (across many surgical subspecialties), only one involved caregivers as partners in the process used to arrive at the provided recommendations [12]
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