All cardiac surgeries require a hospitalization; the length is dependent upon the type of surgery performed. Cardiac surgeries include everything from angioplasty to open heart surgery. The term hospital precautions refers to a set of rules that are followed by the health care practitioners who care for post-surgery cardiac patients. Although these precautions are hospital-specific, there are some generic precautions used for almost all cardiac surgical patients.
Fall Precautions
The University of Maryland Medical Center says that many falls are not age-related, but are usually condition-related. The paraphernalia of surgery, including intravenous line poles, a strange hospital environment and medication effects all set the stage for a fall. Post-cardiac surgical patients take pain medications that can affect balance and coordination. Other medications, such as blood pressure and cardiac drugs, can cause a fall by eliciting a change in blood pressure or heart rate. A fall may be detrimental to a post heart surgery patient by damaging fresh incisions or grafts. Procedures for safe transfer and requirements for supervision while out of bed help ensure cardiac patients' safety.
Infection Control
Nosocomial infections are those that are acquired within the hospital setting. Each hospital has an infection control policy that enforces the use of infection control precautions when necessary. A 2006 article in the "Journal of the American Medical Association" by Patrique Segers, MD and colleagues noted that the incidence of nosocomial infection after cardiac surgery was more than 20 percent. Standard precautions including hand washing and glove and gown use while changing surgical bandages are used within the hospital setting to prevent infections. Visitors may be asked to clean their hands and/or don protective clothing while visiting patients.
Sternal Precautions
Most cardiac surgeries require access to the heart through the sternum, or large breastbone. Open heart surgery, for instance, requires that the surgeon cut through the sternum and close it with wires after the surgery is complete. This unstable sternum can lead to complications, infections and pain if sternal precautions are not followed. These precautions may include limits on exertion such as lifting and moving the upper extremities, and reinforcing the chest with a pillow during coughs or deep breaths.
References
- University of Wisconsin School of Medicine and Public Health: Sternal Precautions
- University of Maryland Medical Center: First Aid--Preventing Falls
- "Journal of the American Medical Association": Prevention of Nosocomial Infection in Cardiac Surgery by Decontamination of the Nasopharynx and Oropharynx with Chlorhexidine Gluconate
- Centers for Disease Control and Prevention: Guidelines for Isolation Precautions in Hospitals--Hospital Infection Control Advisory Committee
