CNS facilitation of a cardiac surgery clinical pathway program.

J. B. Jacavone, R. D. Daniels, I. Tyner

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


In this collaborative project, the Clinical Nurse Specialist (CNS) worked with various members of the healthcare team using a clinical pathway group work process to implement changes in the nursing, medical, and respiratory care of cardiac surgery patients. The patient population (N = 598) comprised cardiac surgery patients undergoing coronary artery bypass graft, mitral valve replacement, or aortic valve replacement. The practice changes implemented were earlier extubation, earlier ambulation, the administration of fentanyl and propofol, and the administration of gastrointestinal (GI) prophylactic medications. The overall outcomes were decreased incidence of pneumonia, earlier increase in level of consciousness, improved ambulation abilities, and improved nausea levels. Pneumonia decreased significantly, from 2.49% to 1.67% (p = 0.05). For patients who met early extubation criteria, mean time on the ventilator decreased from 17 hours to 8 hours, and length of stay decreased from 8 days to 7 days in a subgroup of patients (diagnosis-related group (DRG) 105). The overall annual charge savings was approximately $201,000. These results add to the belief that CNS-guided patient care in collaboration with the healthcare team has positive benefits.

Original languageEnglish (US)
Pages (from-to)126-132
Number of pages7
JournalClinical nurse specialist CNS
Issue number3
StatePublished - May 1999
Externally publishedYes

ASJC Scopus subject areas

  • Leadership and Management
  • Assessment and Diagnosis
  • Advanced and Specialized Nursing
  • LPN and LVN


Dive into the research topics of 'CNS facilitation of a cardiac surgery clinical pathway program.'. Together they form a unique fingerprint.

Cite this