NUR729: Clinical Protocol for Albumin Restricted Fluid Resuscitation in Post-Cardiac Surgery Patients - Medical Science Assignment Help

Assignment Task

Abstract

Background: Hypotension post-cardiac surgery is a prevalent occurrence with multifactorial causes. Fluid resuscitation and volume expansion are crucial to the care of patient’s post-cardiac surgery. Fluid resuscitation in the form of crystalloids like Ringer's lactate and colloids in the form of human serum albumin ( HSA) are used in practice. In cardiac surgery, intravenous fluid resuscitation is critical to ensure adequate intravascular volume, stroke volume, and tissue oxygen delivery, but volume overload is also, consequential. HSA, or plainly albumin for fluid resuscitation, has been ongoing in clinical practice for almost eight decades since it’s use in shock syndrome was first published in the 1940s. Since then, it has been used widely in clinical practice despite the absence of established safety and efficacy in the literature. Albumin's high cost motivated an attempt to reduce its utilization. This clinical protocol will encourage appropriate evidence-based albumin utilization for fluid resuscitation in post-cardiac surgery patients.

Purpose: The purpose of this paper is to create and implement a protocol that will facilitate the proper utilization of albumin in the course of clinical decision-making pertaining to post-cardiac surgical fluid resuscitation.

PICOT Question: In adult, post-cardiac surgery patients, can implementation of a protocol that reduces the use of albumin infusions decrease health care costs and decrease fluid overload in patients?

Methods: Current albumin utilization data will be obtained through a retrospective chart review of post-cardiac surgery patients. Once the guideline is finalized, staff education, for albumin-restricted fluid resuscitation protocol will begin , and post-implementation data will be obtained and compared to evaluate changes. The data will review both albumin utilization and patient outcomes with volume overload and associated financial outcomes.

Anticipated Outcomes: Albumin restriction in the cardiac surgery intensive care unit is feasible and safe with significant reductions in utilization and cost, with no changes in morbidity or mortality. These findings may provide a strategy for reducing costs while maintaining the quality of care.

Nursing Implications :Nursing Implications will be the core of the intervention and evaluation of patient outcomes requiring close monitoring of hemodynamic parameters and signs of volume overload, strict documentation of intake /output, and monitoring for any signs of allergic reaction to albumin.

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