NURSE PRACTITIONER POST CARDIAC SURGERY FOLLOW-UP CLINIC: ENHANCING PATIENT CARE

Abstract

At the Foothills Medical Centre in Calgary, Alberta, the cardiac sciences program has a team of nurse practitioners in both the cardiac surgery and medical cardiology programs. They play a vital role in providing complex care to patients. Readmission to hospital post cardiac surgery led to the development of a nurse practitioner follow up clinic for high risk patients. Examining the data for readmission rates and admitting diagnoses will highlight the need for a follow-up clinic to enhance patient care post cardiac surgery. Pre-operatively, patients will have evaluation and screening for risk factors to optimize their medical management prior to surgery. In the post-operative phase, nurse practitioners manage the care of these medically complex patients, including planning and organizing services for safe discharge. During this time patients who are high risk (no family physician, heart failure management/medication initiation and titration, volume overload or pleural effusions, and wound complications) were identified as a population who would benefit from early reassessment by the nurse practitioner. Since 2012, the nurse practitioners established a follow-up clinic for high risk patients to be re-evaluated within one to two weeks. This model reduced readmission rates, enhanced follow-up disease management and increased patient satisfaction. This clinic was temporarily suspended due to resource scarcity and reduced staffing. Within this period, concern has been raised about increased readmission rates. Therefore, a review of 90 day readmission rates and admitting diagnosis post cardiac surgery was examined and will be discussed. We will present the data and propose a model for post-operative care that includes reimplementation of the nurse practitioner follow-up clinic.