Advertisement
Reducing Postoperative Pulmonary Complications

Reducing Postoperative Pulmonary Complications

Pulmonary complications after surgery are relatively common, occurring in roughly 3% of patients who undergo non-cardiac operations. When compared with other adverse postoperative outcomes, pulmonary complications are also among the most costly. Some analyses have shown that these complications can increase hospital length of stay by as many as 14 days when compared with a lack of these complications. “Clinicians have little guidance on how to prevent pulmonary complications after operations,” says David McAneny, MD. “Efforts to standardize care may reduce the incidence of adverse pulmonary outcomes.” Testing an Intervention In a study published in JAMA Surgery, Dr. McAneny and colleagues tested an intervention designed to reduce the incidence of postoperative pulmonary complications. “Our goal was to create a simple, inexpensive pulmonary care program that was easily understood and remembered by patients, their families, and our staff,” says Dr. McAneny. “We included lung expansion exercises, early and frequent patient mobilization, oral hygiene, and education as key components of our strategy.” In order to facilitate recall of the intervention, the acronym “I COUGH” was developed. I COUGH components included: Incentive spirometry. Coughing and deep breathing. Oral care (brushing teeth and using mouthwash twice daily). Understanding (patient and family education). Getting out of bed frequently (at least three times daily). Head-of-bed elevation. “A critical component of I COUGH is patient education, a process that begins in clinics and continues during preoperative assessments,” explains Dr. McAneny. “Brochures, a video in various languages, and posters with instructions that describe the importance of postoperative pulmonary care were developed.” The multidisciplinary program taught and reinforced principles of the I COUGH interventions. Elements of I COUGH...
[ HIDE/SHOW ]