Intervention reduces postoperative complications

(Nurse.com)A standardized postoperative care program that emphasizes patient education, early mobilization and pulmonary interventions is associated with reduced risk of postoperative pneumonia and unplanned intubation, according to a study.

Michael R. Cassidy, MD, and colleagues at the Boston University Medical Center studied the effects of the program, I COUGH, on all patients who underwent general or vascular surgery at their institution during a one-year period. They compared the National Surgical Quality Improvement Program risk-adjusted pulmonary outcomes before and after implementing the program.

Incidence of postoperative pneumonia decreased from 2.6% before implementation to 1.6% after, while incidence of unplanned intubations decreased from 2% to 1.2%.

“We are eager to monitor our outcomes over a longer period, and we are stimulated by the possibility that postoperative complications may be diminished by adherence to simple, inexpensive, easily performed patient care strategies,” the authors wrote.

I COUGH is an acronym for the elements of the program: Incentive spirometry, Coughing and deep breathing, Oral care (brushing and using mouthwash twice daily), Understanding (patient and family education), Getting out of bed at least three times daily and Head-of-bed elevation.

“Nursing and physician education promoted a culture of mobilization and I COUGH interventions,” the authors wrote.

The study was published June 5 on the website of JAMA Surgery.

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