Implementation of intercostal drainage care protocol for post-operative cardiac patients in post-operative cardiothoracic ICU

Given the importance of nursing care in achieving positive patient outcomes, standardized measures are essential to evaluate and implement nursing interventions as well as quality improvement initiatives. Protocol based nursing care is an effective method in managing the patients with intercostal drains.

This study was undertaken to develop and implement a protocol on ICD care for nurses in cardio-thoracic ICU (CTVS ICU) and to evaluate the effectiveness of the same.

A pre-test post-test design was used to assess the effectiveness of ICD protocol on nurses ’knowledge and practice as well as patient care outcome. The study was conducted among 60 nurses and 175 post-operative cardiac patients, admitted in CTVS ICU. The study had 3 phases: protocol development, implementation and evaluation phase. The ICD care protocol was developed through 4 stages. During the implementation phase, the nurses were given a structured teaching program about the ICD care protocol. Knowledge and practice of nurses were assessed and compared before and two weeks after implementation of the protocol. Further, patient care outcome was assessed and compared between the pre-implementation phase (86 patients) and post-implementation phase (89 patients).

Knowledge of nurses have improved significantly after the implementation of ICD care protocol from 11.11±2.63 to 18.98±1.64 (p<0.001) and the practice score was improved from 4.98±1.33 to 6.61±1.00 (p<0.001). Pre-implementation patient care outcome score of 3.88±40.07 was significantly improved to 4.23±0.07 during the post-implementation phase (p<0.001).

It is concluded that implementation of ICD care protocol has improved the knowledge and practices of nurses related to ICD care as well as patient care outcome. These findings highlight the importance implementing standardized protocol to improve the nursing practice standards and positive patient care outcomes in post-operative patients of cardiothoracic surgery with ICD.