Periop nurses key in reducing readmissions after CABG surgery

Editor's Note

Perioperative nurses engaging in patient and community education to explain coronary artery bypass grafting (CABG) surgery, reinforcing recommended discharge guidelines, and serving as expert resources are key to positive outcomes and reducing readmissions, finds this review article.

In 2016, the Centers for Medicare & Medicaid Services reduced payments for complications that required readmission for CABG patients. Risks specific to CABG patients include saphenous vein harvest site infections and sternal wound problems, which may be aggravated by comorbidities, such as diabetes, COPD, and atrial fibrillation.

Nursing strategies to reduce readmissions include:

• Direct interventions−using AORN’s Guidelines for Perioperative Practice, evidence-appraisal tools, competencies, tool kits, and other resources that enhance practice.
• Indirect interventions−modifying the institution’s culture, level of coordination and collaboration among care providers, and environment of learning to positively affect care.

Regardless of the causes of readmission, safe perioperative patient care will help mitigate complications after CABG surgery, the author says.

Patients who are discharged after undergoing surgery and readmitted within 30 days for complications require expensive treatment that is often avoidable; complications (eg, infection) are also associated with poorer outcomes.1, 2 The 2010 Affordable Care Act was intended to help stem higher-than-expected readmission rates.3 This program imposes financial penalties on health care facilities with excessive readmissions but offers readmission reduction strategies and resources to foster greater patient engagement in discharge planning.3, 4

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