Patient participation in pulmonary interventions to reduce postoperative pulmonary complications following cardiac surgery.
BACKGROUND
Clinical interventions aimed at reducing the incidence of postoperative pulmonary complications necessitate patient engagement and participation in care. Patients' ability and willingness to participate in care to reduce postoperative complications is unclear. Further, nurses' facilitation of patient participation in pulmonary interventions has not been explored.


OBJECTIVE
To explore patients' ability and willingness to participate in pulmonary interventions and nurses' facilitation of pulmonary interventions.


METHODS
Single institution, case study design. Multiple methods of data collection were used including preadmission (n=130) and pre-discharge (n=98) patient interviews, naturalistic observations (n=48) and nursing focus group interviews (n=2).


METHODS
A cardiac surgical ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia.


METHODS
One hundred and thirty patients admitted for cardiac surgery via the preadmission clinic during a 1-year period and 40 registered nurses who were part of the permanent workforce on the cardiac surgical ward.


METHODS
Patients' understanding of their role in pulmonary interventions and patients' preference for and reported involvement in pulmonary management. Nurses' facilitation of patients to participate in pulmonary interventions.


RESULTS
Patients displayed a greater understanding of their role in pulmonary interventions after their surgical admission than they did at preadmission. While 55% of patients preferred to make decisions about deep breathing and coughing exercises, three-quarters of patients (75%) reported they made decisions about deep breathing and coughing during their surgical admission. Nurses missed opportunities to engage patients in this aspect of pulmonary management.


CONCLUSIONS
Patients appear willing to take responsibility for pulmonary management in the postoperative period. Nurses could enhance patient participation in pulmonary interventions by ensuring adequate information and education is provided. Facilitation of patients' participation in their recovery is a fundamental aspect of care delivery in this context.
School of Nursing and Midwifery, Deakin University, Australia. Electronic address: lauren.mctier@deakin.edu.au.
Lauren
L
McTier
School of Nursing and Midwifery, Deakin University, Australia; Epworth Deakin Centre for Nursing Research, Australia.
Mari
M
Botti
School of Nursing and Midwifery, Deakin University, Australia.
Maxine
M
Duke
D000368:Aged; D001315:Australia; D013504:Cardiovascular Surgical Procedures; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000451:nursing / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D011183:Postoperative Complications / Q000451:nursing / Q000517:prevention & control*
Acute care; Patient participation; Postoperative care; Quality and safety