Nurse-led service slashes cancelled heart ops

The service – a joint project between St George’s Hospital Trust and the South West London Cardiac and Stroke Network – was set up in December 2008 to improve the cardiac surgery patient pathway and help the trust meet the 18-week referral to treatment target.

Lead by cardiac nurses, including a cardiothoracic nurse practitioner who co-ordinates the care of cardiac surgery patients, the service has seen the number of theatre cancellations decrease from 10.1 cases per month two years ago to just 2.3 cases per month at present.

Length of hospital stay has also reduced – from 8.8 days to 7.6 days for elective patients, and 15.7 days to 13.3 days for emergencies.

Cardiothoracic nurse practitioner Rebecca Lucas, who has lead the service since last April, said there were “lots of gaps and bottle necks” in the old system, which had resulted in a lot of time wasting and a general lack of communication between staff.

Her role involves organising scans and tests, liaising with cardiologists and surgeons, and being the first point of call for other nurses. She has also introduced guidance on the care of cardiac surgery patients.

Following the introduction on guidance on pre-assessment, almost all elective patients are now pre-assessed prior to their operation compared to just over half under the previous system. This has seen the number of patients admitted on the day of surgery increase from just under 10 per cent to almost 25 per cent.

Ms Lucas said: “The introduction of clear guidance and protocols has reduced inequalities between waiting lists, improved communication between staff and helped improve the patient experience.”

James Buchan, professor of social science and health care at Queen Margaret University College, Edinburgh, said the financial squeeze meant it was an “increasing requirement for nurses in advanced roles to demonstrate their value and contribution to patient care”.

He said: “This is another example that clearly demonstrates the contribution they make to improving patient well being and productivity and efficiency in health services.”

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