A standardized postoperative care program that emphasizes patient education, early mobilization and pulmonary interventions is associated with reduced risk of postoperative pneumonia and unplanned intubation, according to a study.
Michael R. Cassidy, MD, and colleagues at the Boston University Medical Center studied the effects of the program, I COUGH, on all patients who underwent general or vascular surgery at their institution during a one-year period. They compared the National Surgical Quality Improvement Program risk-adjusted pulmonary outcomes before and after implementing the program.
Incidence of postoperative pneumonia decreased from 2.6% before implementation to 1.6% after, while incidence of unplanned intubations decreased from 2% to 1.2%.
We are eager to monitor our outcomes over a longer period, and we are stimulated by the possibility that postoperative complications may be diminished by adherence to simple, inexpensive, easily performed patient care strategies, the authors wrote.
I COUGH is an acronym for the elements of the program: Incentive spirometry, Coughing and deep breathing, Oral care (brushing and using mouthwash twice daily), Understanding (patient and family education), Getting out of bed at least three times daily and Head-of-bed elevation.
Nursing and physician education promoted a culture of mobilization and I COUGH interventions, the authors wrote.
The study was published June 5 on the website of JAMA Surgery.