Date of Award

Fall 9-28-2018

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Nina McLain

Committee Chair Department

Nursing

Committee Member 2

Dr. Michong Rayborn

Committee Member 2 Department

Nursing

Abstract

The number one cause of death in the United States is heart disease. With an increased incidence of heart disease, comes an increased rate of cardiac surgeries. One of the more complicated surgeries related to heart disease is the coronary artery bypass graft (CABG) surgery. One practice currently being used regularly is the use of the pulmonary artery (PA) catheter or a Swan-Ganz catheter. The PA catheter is an invasive tool that lies in the patient’s pulmonary artery and is often used in CABG surgeries to see how the heart is functioning. However, recent research has shown that these catheters actually are more harmful than beneficial to patients and are very expensive. The purpose of this project was to develop a recommendation for the best practice of PA catheter placement in CABG surgeries based on current literature. This particular surgery is already considered to be a high-risk surgery; therefore, anything that can be done to improve patient outcomes is desirable. A thorough review of the literature and a panel of experts were utilized to develop the recommendation for the best practice of PA catheter placement. The research and the panel of experts agree that best practice of PA catheters is to place a PA catheter based on need, rather than using these catheters without discretion in patients undergoing CABG surgeries. Also, if available, anesthesia providers should try to use less invasive alternatives to the PA catheter.

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