Getting better : Nurse practitioner’s research for quality improvement in cardiac surgery

This thesis describes the efforts to reduce complications during and after cardiac surgery and to enhance the quality of patient care during the in-hospital stay after surgery. Several important topics for daily patient care will be addressed. In light of this goal, the scope and aims of the research described in this thesis are to improve patient outcomes after cardiac surgery by researching the following early perioperative and long-term postoperative issues.
1) The effects of a protocol on cessation of anticoagulants and platelet-inhibiting medication on perioperative blood loss.
2) The effect of a novel approach to preventing postoperative wound infections: applying negative topical pressure on a closed wound.
3) Improving pain management after cardiac surgery with a nurse-driven pain protocol.
4) Improving knowledge about the management of rare complications after cardiac surgery by investigating and describing the diagnosis and management of atrio-esophageal fistula after the totally thoracoscopic maze procedure and of prosthetic valve endocarditis with Propionibacterium acnes (P. acnes).