Quality Improvement Project| Cardiac Risk Stratification Prior to Non-Cardiac Surgery

• Main Author: Drexler, Samona Smith
• Language: EN
• Published: University of Louisiana at Lafayette 2016
• Subjects: Nursing|Surgery
• Online Access: http://pqdtopen.proquest.com/#viewpdf?dispub=10163292

<p> The occurrence of major adverse cardiac events (MACE) is a common perioperative complication and contributing factor for the increase risk of morbidity and mortality in adult patients undergoing non-cardiac surgery. The most reasonable and evidence-based option to reduce the risk of MACE and perioperative morbidity and mortality is a consistent assessment of the functional capacity for non-cardiac patients prior to non-cardiac surgical procedures. According to Fleisher et al. (2014), individuals with a decreased or unmeasurable functional capacity should be referred to a cardiologist for evaluation and cardiac risk stratification prior to surgery. The Duke Activity Status Index (DASI) tool has demonstrated to be an effective tool in assessing functional capacity and identifying individuals without a known cardiac history who may be at risk for perioperative cardiac complications. </p><p> This quality improvement project focused on the implementation and use of the DASI tool into the preexisting formal preoperative procedure. Use of the DASI tool focused on accurate measurements of the surgical patient&rsquo;s functional capacity and evaluation of potential risk factors for MACE. As a result of using the DASI tool in the preoperative process, several non-cardiac adult patients were recognized as being at risk for MACE and underwent cardiac interventional procedures following referral to a cardiologist for preoperative evaluation. Assessing functional capacity using the DASI tool prior to non-cardiac surgical procedures has proven to be both valuable and medically beneficial for the non-cardiac adult patients in evaluation of the risk for MACE.</p>