Title : Transforming post-cardiac surgery resuscitation: implementing the Society of Thoracic Surgeons (STS) guidelines for better outcomes
Abstract:
Purpose: This project implements Society of Thoracic Surgeons resuscitation guidelines for post–cardiac surgery patients, addressing needs unmet by standard ACLS. The initiative aims to enhance safety, reduce complications, and build staff confidence and performance in cardiac care.
Relevance/Significance: A systematic review identified three pivotal studies on resuscitation after cardiac surgery. Dunning et al. (2017) emphasize specialized protocols for post-cardiac surgery patients. Key recommendations include a multidisciplinary approach, immediate defibrillation, and emergency re-sternotomy. Ley (2019) advocates for specialized protocols. Michaelis and Leone (2019) highlight differences from standard ACLS. This evidence highlights the need for specialized protocols to improve care and outcomes.
Strategy/Implementation/Methods: To support adoption of STS resuscitation guidelines, implementation strategies included a video presentation, posters in post?surgery units, and personalized one?on?one sessions to strengthen staff confidence. The guidelines were
incorporated into ICU internships, classroom lectures, in?services, and huddles, with feedback forms promoting continuous improvement. Our hospital, with five inpatient units, with three dedicated to recovering immediate post?cardiac surgery, is developing a consensus?based protocol. Key stakeholders, including nursing leadership, cardiovascular surgery, the Code Blue committee, and the Staff Nurse Council, are driving implementation through ongoing education.
Evaluation/Outcomes/Results: A retrospective analysis of 20 post-cardiac surgery code blue patients compared STS vs. ACLS protocols. In the ACLS group (17 patients), 2 died and 5 expired before discharge, with LOS 10–56 days. All 3 STS patients survived, were discharged
home (LOS 6–9 days), required no return to OR or massive transfusions, and had shorter time to ROSC with better neurological outcomes. These findings demonstrate that STS protocols improve survival, reduce hospital stays, enhance recovery, and strengthen patient safety compared to standard ACLS.
Conclusions/Implications for Practice: This project improves patient safety through specialized post-cardiac surgery resuscitation protocols, supporting evidence-based practice.
It positions the organization as a leader in cardiac care. Next steps include publishing guidelines, educating staff, and conducting audits to sustain improved outcomes and satisfaction.
