Nursing Care Protocol for Patients Undergoing Cardiac Surgery amidst COVID-19 Outbreak Situation: From Evidence-Based Practice to Clinical Nursing Practice
Main Article Content
Abstract
Currently, the pandemic situation of coronavirus disease 2019 (COVID-19) is spreading around the world and is becoming seriously critical. This situation affects health care systems that have to deal with the rising number of patients and limited medical resources. Patients who undergo cardiac surgery, whether in the pre-surgical or surgical phase, are therefore at higher risk of getting COVID-19 infection and increasing the severity of disease into a crisis. Nurses and medical personnel are the frontlines who play critical roles in assessing, screening, and caring for patients undergoing cardiac surgery both urgent and non-urgent to alleviate poor prognosis due to surgical delay.
We reviewed evidence to present the knowledge of care protocol for patients undergoing cardiac surgery and patients with COVID-19 who need for cardiac surgery during the COVID-19 pandemic. The nursing care protocol developed from evidence promotes better outcomes for patients, controls and prevents the spread of COVID-19, and provides safe practice for nurses and medical personnel.
Article Details
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264-6. doi: 10.1016/j.ijid.2020.01.009.
World Health Organization. Origin of SARS-CoV-2 [Internet]. Geneva: World Health Organization; 2020 [cited 2021 Aug 2]. Available from: https://apps.who.int/iris/handle/10665/332197.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020;382(13):1199-207. doi: 10.1056/NEJMoa2001316.
Sirilak S, editor. Thailand’s experience in the COVID-19 response [Internet]. Nonthaburi: Ministry of Public Health; 2020 [cited 2021 Aug 2]. Available from: https://ddc.moph.go.th/viralpneumonia/eng/file/pub_doc/LDoc9.pdf.
Department of Disease Control, Ministry of Public Health. Coronavirus disease 2019 situation report [Internet]. Nonthaburi: Department of Disease Control, Ministry of Public Health; 2021 [cited 2021 Aug 2]. Available from: https://ddc.moph.go.th/viralpneumonia/file/situation/situation-no475-220464.pdf. (in Thai).
Department of Disease Control, Bureau of Non-communicable Diseases, Ministry of Public Health. NCDs situation report 2019, diabetes, hypertension and related risk factors [Internet]. Nonthaburi: Department of Disease Control, Ministry of Public Health; 2021 [cited 2021 Aug 2]. Available from: https://ddc.moph.go.th/uploads/publish/1035820201005073556.pdf. (in Thai).
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648.
World Health Organization. Coronavirus disease 2019 (COVID-19): situation report-61. [Internet]. Geneva: World Health Organization; 2020 [cited 2021 Aug 2]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200321-sitrep-61-covid-19.pdf?sfvrsn=ce5ca11c_2.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: 10.1001/jama.2020.1585.
Xiong T-Y, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798–800. doi: 10.1093/eurheartj/ehaa231.
Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247-50. doi: 10.1016/j.dsx.2020.03.013.
Engelman DT, Lother S, George I, Ailawadi G, Atluri P, Grant MC, et al. Ramping up delivery of cardiac surgery during the COVID-19 pandemic: a guidance statement from the society of thoracic surgeons COVID-19 task force. Ann Thorac Surg. 2020;110(2):712-7. doi: 10.1016/j.athoracsur.2020.05.002.
Chikwe J, Gaudino M, Hameed I, Robinson NB, Bakaeen FG, Menicanti L, et al. Committee recommendations for resuming cardiac surgery activity in the SARS-CoV-2 era: guidance from an international cardiac surgery consortium. Ann Thorac Surg. 2020;110(2):725-32. doi: 10.1016/j.athoracsur.2020.05.004.
Haft JW, Atluri P, Ailawadi G, Engelman DT, Grant MC, Hassan A, et al. Adult cardiac surgery during the COVID-19 pandemic: a tiered patient triage guidance statement. Ann Thorac Surg. 2020;110(2):697-700. doi: 10.1016/j.athoracsur.2020.04.003.
Hassan A, Arora RC, Adams C, Bouchard D, Cook R, Gunning D, et al. Cardiac surgery in Canada during the COVID-19 pandemic: a guidance statement from the Canadian Society of Cardiac Surgeons. Can J Cardiol. 2020;36(6):952-5. doi: 10.1016/j.cjca.2020.04.001.
Hiremath CS, Yadava OP, Meharwal ZS, Iyer KS, Velayudhan B. IACTS guidelines: practice of cardiovascular and thoracic surgery in the COVID-19 era. Indian J Thorac Cardiovasc Surg. 2020;36(5):1-13. doi: 10.1007/s12055-020-01016-w.
Siriwittayakorn P. Announcement of the Royal College of Surgeons of Thailand on guidance for surgery in COVID-19 patients. Siriraj Med J. 2020;72(5):431-5. doi: 10.33192/Smj.2020.58.
Al Thobaity A, Alshammari F. Nurses on the frontline against the COVID-19 pandemic: an integrative review. Dubai Medical Journal. 2020;3(3):87-92. doi: 10.1159/000509361.
Joo JY, Liu MF. Nurses’ barriers to caring for patients with COVID-19: a qualitative systematic review. Int Nurs Rev. 2021;68(2):202-13. doi: 10.1111/inr.12648.
Julawong O, Munsil J, Taweewanich S. Application of evidence-based practice in nursing professions. Journal of The Royal Thai Army Nurses. 2018;19(2):8-14. (in Thai).
Thongchai C. Clinical practice guidelines development. The Thai Journal of Nursing Council. 2012;20(2):63-76. (in Thai).
Picheansathian W. Searching for evidence: essential skills of nurses in Thailand 4.0. Thai Journal of Nursing and Midwifery Practice. 2018;5(1):136-48. (in Thai).
Centers for Disease Control and Prevention. Healthcare workers: information on COVID-19. Atlanta, GA: Centers for Disease Control and Prevention; 2021 [cited 2021 Aug 2]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html.
Thongngam S, Pumool S, Ratanarat R. Nursing care for patients with COVID-19 in the isolation unit, Siriraj Hospital. Siriraj Medical Bulletin. 2020;13(3):221-31. doi: 10.33192/Simedbull.2020.29. (in Thai).
Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666-87. doi: 10.1093/cvr/cvaa106.
The European Society for Cardiology. ESC guidance for the diagnosis and management of CV disease during the COVID-19 pandemic. Sophia Antipolis Cedex, France: European Society of Cardiology; 2020 [cited 2021 Aug 2]. Available from: https://www.escardio.org/static-file/Escardio/Education-General/Topic%20pages/Covid-19/ESC%20Guidance%20Document/ESC-Guidance-COVID-19-Pandemic.pdf.
Gunaydin S, Stammers AH. Perioperative management of COVID-19 patients undergoing cardiac surgery with cardiopulmonary bypass. Perfusion. 2020;35(6):465-73. doi: 10.1177/0267659120941341.
Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6. doi: 10.1111/jth.14810.
Casini A, Alberio L, Angelillo-Scherrer A, Fontana P, Gerber B, Graf L, et al. Suggestions for thromboprophylaxis and laboratory monitoring for in-hospital patients with COVID-19. Swiss Med Wkly. 2020;150:w20247. doi: 10.4414/smw.2020.20247.
Stephens RS, Whitman GJ. Postoperative critical care of the adult cardiac surgical patient. Part I: routine postoperative care. Crit Care Med. 2015;43(7):1477-97. doi: 10.1097/CCM.0000000000001059.
Siriratwarangkul S. Complications after open heart surgery at Suratthani Hospital. Thai Journal of Anesthesiology. 2020;46(1):7-14. (in Thai).
Irons JF, Pavey W, Bennetts JS, Granger E, Tutungi E, Almeida A. COVID-19 safety: aerosol-generating procedures and cardiothoracic surgery and anaesthesia - Australian and New Zealand consensus statement. Med J Aust. 2021;214(1):40-4. doi: 10.5694/mja2.50804.
Ghoniem A, Abdellateef A, Osman AI, Elsayed HH, Elkhayat H, Adel W. A tentative guide for thoracic surgeons during COVID-19 pandemic. Cardiothorac Surg. 2020;28(1):16. doi: 10.1186/s43057-020-00026-z.
D'Silva DF, McCulloch TJ, Lim JS, Smith SS, Carayannis D. Extubation of patients with COVID-19. Br J Anaesth. 2020;125(1):e192-e5. doi: 10.1016/j.bja.2020.03.016.
Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352-71. doi: 10.1016/j.jacc.2020.03.031.
Kochaiyapatana P, Koowattanatienchai S. Coronavirus disease 2019 (COVID-19) and cardiac arrhythmias. Burapha Journal of Medicine. 2020;7(1):153-64. (in Thai).