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Title: Application of Checklist-Based Nursing Care Process in Patients Undergoing Intervention for Coronary Chronic Total Occlusion: A Quasi-Randomized Study Presenter: Sonia Pal, M.Sc. Nursing 2nd Year Journal: BMC Nursing (2023) Authors: Xia Ge, Haiyang Wu, Zhe Zang, and Jiayi Xie DOI: 10.1186/s12872-023-03627-8 Study Overview: This presentation focuses on the effectiveness of a checklist-based nursing care process for patients undergoing interventions for coronary chronic total occlusion (CTO). The study employs a quasi-randomized design to assess improvements in patient care outcomes. Key Points: Background: CTO interventions are complex, and traditional nursing methods have not been highly effective, necessitating the exploration of new approaches. Objective: To investigate the effectiveness of a checklist-based nursing care process in improving care quality, reducing patient anxiety, increasing patient satisfaction, and minimizing adverse events. Methodology: Design: Quasi-randomized study Setting: Department of Cardiology, Shengjing Hospital, China Medical University, Shenyang, China Participants: 120 patients undergoing CTO interventions Groups: Intervention group (checklist-based care) and control group (standard care) Tools: Preoperative and postoperative PCI nursing care checklists, Zung Self-Rating Anxiety Scale, satisfaction questionnaires for doctors and patients Ethical Considerations: The study adhered to the Declaration of Helsinki, with informed consent obtained from all participants. Results: The study aimed to demonstrate that checklist-based nursing care could enhance nursing efficiency and patient outcomes compared to conventional methods. Quality Control: A quality control team ensured adherence to the checklist and study protocol, with regular training and supervision of nursing staff. Conclusion: The presentation concludes with findings supporting the effectiveness of checklist-based nursing care in CTO interventions, suggesting improvements in patient care processes and outcomes. The study highlights the importance of structured nursing protocols in complex medical procedures.

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Thoracotomy is the surgical procedure with an incision made to access the pleural space and the contents of the thoracic cavity. Given the structures to be accessed with in the cavity, different incisions have been established to easy the procedure and these incisions qualify the types of thoracotomies to be studied hereunder. PRE OP OPTIMIZATION FOR SPECIFIC FACTORS The outcome of surgical procedures is not measured only by clinical end points but also shorter stays and lower costs. Patients’ discharge is delayed commonly due to inadequate pain relief, infection, arrhythmias, prolonged air leak and debility. Many complications that occur from thoracic operations can be anticipated. An aggressive preoperative work up mitigates morbidity and shortens convalescence. APPROACH CONSIDERATIONS There are about three principles that can guides the choice of the thoracotomy incision to be used I. Adequate exposure must be achieved. The choice of incision is aided by a thorough understanding of the surface anatomy and a comprehensive review of the radiographic images that are obtained preoperatively. II. Chest-wall function and appearance should be preserved to the extent possible. This principle include non-spreading video-assisted thoracoscopic surgery (VATS) procedures, muscle-sparing techniques, avoidance of excessive rib retraction, and rib preservation when possible. III. The third principle is that closure must be meticulous and appropriate. Strict layered closure is the rule for thoracic surgical incisions. Every effort should be made to approximate the individual divided chest-wall muscles in appropriate layers; otherwise, a significant delay in the recovery of range of motion (ROM) may result. Care must be taken to avoid over approximating the ribs and to prevent an override; this will help minimize postoperative pain. POST-OPERATIVE CARE AND MONITORING

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