Журнал сестринского дела и ухода

Assessment Of Blood Pressure For Determining The Time To Perform First Postural Change In Patients After Cardiac Surgery In The Intensive Care Unit

Abstract

Sachiko Nagaya, Etsuko Fujimoto and Hiromitsu Kobayashi

Objective: Changing the posture of patients is an integral part of nursing care. However, postural changes after cardiac surgery can have potential adverse effects on patients. To prevent these effects, an appropriate assessment of the patient’s condition is necessary. This study aimed to clarify the assessment by nurses to determine the timing to perform the first postural change in patients who have undergone cardiac surgery, with special reference to changes in blood pressure. Methods: A qualitative study using semistructured interviews was conducted among registered nurses working in an intensive care unit of a hospital. Results: Participants (n = 12) focused on four factors when interpreting a patient’s blood pressure: “rewarming,” “circulatory blood volume,” “cardiac output,” and “body movements.” Participants assessed their patients based on two criteria: the first emphasizing specific blood pressure values and the second focusing on stability of the blood pressure, representing static and dynamic parameters, respectively. Nurses made an appropriate assessment by careful consideration of these two criteria. Conclusion: The present results demonstrate that the assessment of blood pressure includes four factors. We propose that the assessment of dynamic changes in blood pressure are required in addition to the static status. This study may support nurse’s assessment for the first postural change in patients after cardiac surgery.