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Nursing Research and Practice - Volume 2016 2016, Article ID 9505629, 7 pages -

Research Article

Texas AandM University Health Science Center, College of Nursing, Bryan-College Station, TX, USA

Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

Department of Pediatrics, University of Nebraska, Division of Pediatric Cardiology, Lincoln, NE, USA

Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

Department of Family and Community Health Systems, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

University Health System, San Antonio, TX, USA

Received 6 January 2016; Revised 4 April 2016; Accepted 14 April 2016

Academic Editor: Patrick Callaghan

Copyright © 2016 Cindy Weston et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-Whitney tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-age -score WAZ and shorter length of stay LOS following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of 500,000 to 800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs.





Autor: Cindy Weston, S. Adil Husain, Christopher L. Curzon, Steve Neish, Gemma T. Kennedy, Krista Bonagurio, and Kevin Gosselin

Fuente: https://www.hindawi.com/



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