Postoperative Nursing Care of Cardiac Patients Following Coronary Artery Bypass Surgery After 24 Hours
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Abstract
Coronary heart disease is a significant public health problem, serving as a major cause of morbidity and mortality among the global population. It impacts healthcare systems and creates an increasing burden of medical treatment costs. Coronary Artery Bypass Graft Surgery (CABG) is one of the highly effective treatment approaches for coronary heart disease, helping to reduce chest pain symptoms, decrease mortality rates, increase survival chances, and improve patients' quality of life. However, surgery still carries risks of complications that may result in patient death, prolonged hospital stays, increased reoperation rates, increased readmission rates, higher treatment costs, and reduced patient quality of life. Therefore, nurses play a crucial role in caring for patients after coronary artery bypass graft surgery. They must develop competencies, knowledge, and skills in patient care, monitor changes, prevent complications, and provide guidance on self-care practices to prepare for discharge. This involves providing nursing care according to the 5-step nursing process to ensure quality, safe care that comprehensively addresses patients' health needs in physical, mental, and social aspects. This will help prevent complications, reduce hospital length of stay, decrease treatment costs, reduce readmission rates, and lower mortality rates. Additionally, patients will be able to appropriately care for their health and have better well-being and quality of life.
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References
Bauersachs R, Zeymer U, Brière JB, Marre C, Bowrin K, Huelsebeck M. Burden of coronary artery disease and peripheral artery disease: a literature review. Cardiovasc Ther. 2019;2019:8295054.
Martin SS, Aday AW, Allen NB, Almarzooq ZI, Anderson CAM, Arora P, et al. 2025 Heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2025;151(8):e41-660.
Bozkur T, Saglam R. Symptoms and care satisfaction in patients who underwent coronary artery bypass graft surgery. Clin Exp Health Sci. 2021;11(3):481-6.
กองยุทธศาสตร์และแผนงาน สํานักงานปลัดกระทรวงสาธารณสุข. สถิติสาธารณสุข 2565. นนทบุรี: กระทรวงสาธารณสุข; 2566.
Zeinali-Nezhad N, Najafipour H, Shadkam M, Pourhamidi R. Prevalence and trend of multiple coronary artery disease risk factors and their 5-year incidence rate among adult population of Kerman: results from KERCADR study. BMC Public Health. 2024;24(1):25.
Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the management of patients with chronic coronary disease: a report of the American Heart Association/American College of Cardiology Joint Committee on clinical practice guidelines. Circulation. 2023;148(9):e9-119.
สมาคมแพทย์โรคหัวใจแห่งประเทศไทย ในพระบรมราชูปถัมภ์. แนวเวชปฏิบัติการดูแลรักษาผู้ป่วยภาวะหัวใจขาดเลือดเรื้อรัง พ.ศ.2564. กรุงเทพฯ: สมาคมแพทย์โรคหัวใจแห่งประเทศไทย ในพระบรมราชูปถัมภ์; 2565.
Davidson LJ, Cleveland JC, Welt FG, Anwaruddin S, Bonow RO, Firstenberg MS, et al. A practical approach to left main coronary artery disease: JACC state-of-the-art review. J Am Coll Cardiol. 2022;80(22):2119-34.
Arsyi DH, Permana PBD, Karim RI, Abdurachman. The role of optimism in manifesting recovery outcomes after coronary artery bypass graft surgery: a systematic review. J Psychosom Res. 2022;162:111044.
สมาคมศัลยแพทย์ทรวงอกแห่งประเทศไทย. สถิติผ่าตัดหัวใจในประเทศไทย [อินเทอร์เน็ต]. 2567 [เข้าถึงเมื่อ 3 ก.ค. 2568]. เข้าถึงได้จาก: https://www.thaists.or.th/download-category/statistics-on-heart-surgery-in-thailand/#.
Audet LA, Lavoie-Tremblay M, Tchouaket É, Kilpatrick K. The level of adherence to best-practice guidelines by interprofessional teams with and without acute care nurse practitioners in cardiac surgery: a study protocol. PLoS One. 2023;18(3):e0282467.
Open Resources for Nursing (Open RN). Part IV Nursing process. In: Open Resources for Nursing (Open RN), Ernstmeyer K, Christman E, editors. Nursing fundamentals [Internet]. 2nd ed. Eau Claire (WI): Chippewa Valley Technical College; 2024 [cited 7 Jul 2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/.
Ho MH, Montgomery A, Traynor V, Chang CC, Kuo KN, Chang HR, et al. Diagnostic performance of delirium assessment tools in critically Ill patients: a systematic review and meta-analysis. Worldviews Evid Based Nurs. 2020;17(4):301-10.
Tieges Z, Maclullich AMJ, Anand A, Brookes C, Cassarino M, O’connor M, et al. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age and Ageing. 2020;50(3):733-43.
Öner Cengiz H, Uluşan Özkan Z, Gani E. The effect of preoperative deep breathing exercise with incentive spirometer initiated in the preoperative period on respiratory parameters and complications in patients underwent open heart surgery: a randomized controlled trial. BMC Anesthesiol. 2025;25(1):36.
Sweity EM, Alkaissi AA, Othman W, Salahat A. Preoperative incentive spirometry for preventing postoperative pulmonary complications in patients undergoing coronary artery bypass graft surgery: a prospective, randomized controlled trial. J Cardiothorac Surg. 2021;16(1):241.
de la Varga Martínez O, Lorenzo-López M, Tamayo Gómez E. Basic concepts of critical care following cardiac surgery. In: Vives M, Hernandez A, editors. Cardiac anesthesia and postoperative care in the 21st Century. Cham: Springer International Publishing; 2022. p. 313-21.
Tzoumas A, Nagraj S, Tasoudis P, Arfaras-Melainis A, Palaiodimos L, Kokkinidis DG, et al. Atrial Fibrillation Following Coronary Artery Bypass Graft: Where Do We Stand? Cardiovasc Revasc Med. 2022;40:172-9.
Salenger R, Arora RC, Bracey A, D’Oria M, Engelman DT, Evans C, et al. Cardiac surgical bleeding, transfusion, and quality metrics: joint consensus statement by the enhanced recovery after surgery cardiac society and society for the advancement of patient blood management. Ann Thorac Surg. 2025;119(2):280-95.
Hasan MT, Hagrass AI, Elkhrashy MN, Hamouda M, shada NM, Hashem SM, et al. Effectiveness of active chest tube clearance versus conventional chest tube in reducing postoperative complications after cardiac surgery: a systematic review and meta-analysis. SN Compr Clin Med.. 2022;4(1):177.
Perry AG, Potter PA, Ostendorf WR, Laplante N. Clinical nursing skills and techniques. 11th ed. St. Louis, MO: Mosby; 2024.
Wissman KM, Cassidy E, D'Amico F, Hoy C, Vissari T, Baumgartner M. Improving pain reassessment and documentation rates: a quality improvement project in a teaching hospital's emergency department. J Emerg Nurs. 2020;46(4):505-10.
คณะกรรมการเภสัชกรรมและการบําบัด โรงพยาบาลศิริราช. คู่มือการใช้ยาที่มีความเสี่ยงสูง. พิมพ์ครั้งที่ 6 (ฉบับปรับปรุง). กรุงเทพฯ: โรงพยาบาลศิริราช; 2565.
Vizerie L, Morales T, Galey S, Montel F, Velly L, Bruder N, et al. Risk factors and pain management in the incidence of postoperative delirium in elderly patients: a retrospective study. J Clin Med. 2024;13(24):7624.
Santoso JDCA, Yulianti E. Pain-induced delirium in patient with dementia: a case report and narrative review. J Pain Palliat Care Pharmacother. 2025;39(1):74-85
Viikinkoski E, Aittokallio J, Lehto J, Ollila H, Relander A, Vasankari T, et al. Prolonged systemic inflammatory response syndrome after cardiac surgery. J Cardiothorac Vasc Anesth. 2024;38(3):709-16.
Seth I, Lim B, Cevik J, Gracias D, Chua M, Kenney PS, et al. Impact of nutrition on skin wound healing and aesthetic outcomes: A comprehensive narrative review. JPRAS Open. 2024;39:291-302.
Kurt Y, Kaşikçi M, Malaska R. Nursing interventions to prevent pressure injury among open heart surgery patients: A systematic review. Nurs Crit Care. 2024;29(6):1706-20.
Potter PA, Perry AG. Potter & Perry’s pocket guide to nursing skills & procedures, 10th Ed. Philadelphia, PA: Elsevier; 2024.
Aykut A, Salman N, Demir ZA, Özgök A, Günaydın S. Comparison of propofol and sevoflurane anaesthesia in terms of postoperative nausea-vomiting complication in cardiac surgery patients undergoing enhanced recovery after surgery protocol: a prospective randomized study. Turk J Anaesthesiol Reanim. 2024;52(3):113-21.
Morton-Bailey V, Salenger R, Engelman DT. The 10 commandments of ERAS for cardiac surgery. Innovations. 2021;16(6):493-7.
Borges MGB, Borges DL, Ribeiro MO, Lima LSS, Macedo KCM, Nina V. Early mobilization prescription in patients undergoing cardiac surgery: systematic review. Braz J Cardiovasc Surg. 2022;37(2):227-38.
Chuntratip N, Borvornsudhasin P, Tippinit S. The development of clinical nursing practice guideline (CNPG) for patients undergoing coronary artery bypass graft surgery. Clin Crit Care. 2025;33:e250013.