Stephanie L. Siehr, MD, Jana K. Norris, NP, Julie A

Slides:



Advertisements
Similar presentations
Max B. Mitchell, MD  The Journal of Thoracic and Cardiovascular Surgery 
Advertisements

Lost in translation The Journal of Thoracic and Cardiovascular Surgery
Manuel J. Antunes, MD, PhD, DSc 
Stephen R. Broderick, MD, MPHS 
New approach to interstage care for palliated high-risk patients with congenital heart disease  Nancy C. Dobrolet, MD, Jo Ann Nieves, MSN, CPN, ARNP,
Effect of feeding modality on interstage growth after stage I palliation: A report from the National Pediatric Cardiology Quality Improvement Collaborative 
Surgery for congenital diseases of the aorta
Long-term mechanical circulatory support: A new disease state?
Prediction of severe acute kidney injury after pediatric cardiac surgery with the use of novel biomarkers: A new trend in clinical research and risk stratification 
Neel R. Sodha, MD, Frank W. Sellke, MD 
Cardiac tumors: To treat or not to treat (or both)?
Centers for Disease Control “increased-risk” organ donor: Not so risky?  Francis D. Pagani, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery 
Devendra K. Agrawal, PhD, MBA, Chandra S. Boosani, PhD 
Form ever follows function
William M. DeCampli, MD, PhD 
The Journal of Thoracic and Cardiovascular Surgery
Skinning the cat: Another wrinkle for T-tube insertion
Application of a neuroscience research model to study neuroprotection in children with congenital heart disease  Nobuyuki Ishibashi, MD, Richard A. Jonas,
How should we treat air leaks?
Resuscitation practices in cardiac surgery
Bigger The Journal of Thoracic and Cardiovascular Surgery
Risk-corrected impact of mechanical versus bioprosthetic valves on long-term mortality after aortic valve replacement  Ole Lund, MD, PhD, Martin Bland,
The lord of the rings  Antonio Miceli, MD, PhD 
Certification in cardiothoracic surgical critical care: A distinction for some or for all?  Nicholas D. Andersen, MD  The Journal of Thoracic and Cardiovascular.
In type A aortic dissection repair, an effective team approach and relational coordination are more important for patients' outcomes than surgeon volume 
New approach to interstage care for palliated high-risk patients with congenital heart disease  Nancy C. Dobrolet, MD, Jo Ann Nieves, MSN, CPN, ARNP,
Online network of subspecialty aortic disease experts: Impact of “cloud” technology on management of acute aortic emergencies  Paul Schoenhagen, MD, Eric.
Expanding left ventricular assist device use to patients with disabilities: The role of assistive technology  Juan A. Crestanello, MD  The Journal of.
Aditya K. Kaza, MD  The Journal of Thoracic and Cardiovascular Surgery 
Juan N. Pulido, MD  The Journal of Thoracic and Cardiovascular Surgery 
Support Your Specialty
The assessment of cost effectiveness and the effectiveness of cost assessment in cardiothoracic surgery  Vinay Badhwar, MD  The Journal of Thoracic and.
It's not “just a shunt” but sometimes it should be…
Stephen R. Broderick, MD, MPHS 
Get it right the first time
Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005  Scott D. Barnett, PhD,
Niv Ad, MD, Lawrence M. Wei, MD 
Frank C. Spencer, MD, FACS, pioneering cardiothoracic surgeon
A fate worse than death  Jennifer S. Lawton, MD 
Marc Licker, MD, John Diaper, RA 
Passing the torch The Journal of Thoracic and Cardiovascular Surgery
Sutureless valve implantation: Every detail counts
Patients with unbalanced atrioventricular canal defects can undergo the Fontan operation with good outcomes  Sitaram M. Emani, MD  The Journal of Thoracic.
The harder one looks, the more one finds
Syphilitic aortitis: The bigger picture
The origins of open heart surgery at the University of Minnesota 1951 to 1956  Richard A. DeWall, MD  The Journal of Thoracic and Cardiovascular Surgery 
How much does early fundoplication for lung transplant recipients with gastroesophageal reflux disease truly help? Challenges in escaping the perils of.
Bryan M. Burt, MD  The Journal of Thoracic and Cardiovascular Surgery 
The Journal of Thoracic and Cardiovascular Surgery
Discussion The Journal of Thoracic and Cardiovascular Surgery
The future of cardiac surgery training: A survival guide
Commentary: “Isn't cardiac surgery a team sport?”
Apparently, size matters…in congenital heart disease and brain injury
Ventricular assistant in restrictive cardiomyopathy: Making the right connection  Robert D.B. Jaquiss, MD  The Journal of Thoracic and Cardiovascular Surgery 
The continuing challenge of congenital heart disease in China
When should the elephant (frozen elephant trunk) enter the room (aorta)?  Frank A. Baciewicz, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume.
Bicuspid aortopathy: Seeing the forest for the trees
The Robin Hood principle in the treatment of congenital heart disease: Taking technologic developments intended for adults and using it in kids  Paul.
“The more things change…”: The challenges ahead
Appropriate Use Criteria for coronary revascularization in patients with stable ischemic heart disease: What the surgeon needs to know  Harold L. Lazar,
First in line for robotic surgery: Would you want to know?
Apples remain apples NO matter what
Respect the aorta The Journal of Thoracic and Cardiovascular Surgery
The evolution of cardiothoracic critical care
Samuel Kim, MD  The Journal of Thoracic and Cardiovascular Surgery 
Michael T. Ingram, MS, David H. Wisner, MD, David T. Cooke, MD 
Journal changes and initiatives
Lessons learned from Melody valve retrieved at transplantation
Calpain inhibitors: The aspirin of the 21st century?
Paul Philipp Heinisch, MD, Thierry Carrel, MD 
Presentation transcript:

Home monitoring program reduces interstage mortality after the modified Norwood procedure  Stephanie L. Siehr, MD, Jana K. Norris, NP, Julie A. Bushnell, NP, Chandra Ramamoorthy, MD, V. Mohan Reddy, MD, Frank L. Hanley, MD, Gail E. Wright, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 147, Issue 2, Pages 718-723.e1 (February 2014) DOI: 10.1016/j.jtcvs.2013.04.006 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Key components of HMP. HMP, Home monitoring program; NP/PA, nurse practitioner/physician assistant; CVICU, cardiovascular intensive care unit; PCARD, primary cardiologist; PMD, primary care physician; HR, heart rate; O2 sats, oxygen saturations; ED, emergency department; LPCH, Lucile Packard Children’s Hospital. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 718-723.e1DOI: (10.1016/j.jtcvs.2013.04.006) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Route of enteral feeding for HMP patients. GT, G tube; PO, by mouth; NG, nasogastric. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 718-723.e1DOI: (10.1016/j.jtcvs.2013.04.006) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 When there were clinical concerns from either the parent or the NP, an action plan was created. Depending on the severity of the concern, the patient was seen by a clinician or the HMP call frequency was increased. Overall, symptoms were presumed to be cardiac in nature until proven otherwise, and there was a low threshold to have the patient seen whenever any issues arose throughout the interstage period. Patients were sent to their primary cardiologist’s office for most problems, but there were many effective variations to this algorithm. In some cases, the primary care provider was involved integrally, and in other scenarios the majority of communication occurred between the HMP team and the primary cardiologist. The emphasis was always on very close, direct communication between the family, the HMP team, the primary cardiologist, and the pediatrician. The HMP NPs documented all calls in the LPCH electronic medical record, so concerns and plans were accessible to all HMP team members and to on-call cardiology fellows. NP, Nurse practitioner; HMP, home monitoring program; GERD, gastroesophageal reflux disease; ED, emergency department. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 718-723.e1DOI: (10.1016/j.jtcvs.2013.04.006) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions