Nurses' Performance regarding Using of APACHE Score: Its Effect on Outcomes of Patients with Cardiac Surgery

Abstract

The acute physiology and chronic health evaluation system is used to assess the severity of disease. Once organ failure develops, monitoring of laboratory values and hemodynamic parameters should be used to assess the degree of impairment. This study aimed to assess nurses' performance regarding using of APACHE scoring system and its effect on outcomes of patients with cardiac surgery. A quasi-experimental research design (one group pretest and posttest) was utilized to achieve the aim of this study. A convenience sample of all available nurses (50) working in the cardiac surgery intensive care units at Ain Shams Specialized Hospital, and in the Cardiovascular and Thoracic Academy affiliated to Ain shams university hospitals. A purposive sample of (130) patients with cardiac surgery were included in the study. Nurses’ knowledge self-administered questionnaire, nurses’ observation checklist, nurses’ attitude scale, patient assessment questionnaire and nursing sensitive patient outcomes measuring scale were used to collect data. The results showed a highly statistically significant difference between mean score of total nurses’ level of knowledge, practice and attitude pre and post the implementation of the educational program. Also, a highly statistically significant difference was found between total score of patient outcomes pre and post implementation of the educational program. Implementing an educational program has a positive effect on nurses’ performance; the APACHE score has an efficient and comparable discriminative ability to predict the outcomes of patients with cardiac surgery. It was recommended to conducting periodic training program for cardiac surgery intensive care units’ nurses in order to keep them with the updated knowledge, practice regarding using of APACHE scoring system to predict the outcomes and complications among patients with cardiac surgery during the first 24 hours.