Nurse and patient factors that influence nursing time in chest tube management early after open heart surgery: A descriptive, correlational study.

PURPOSE: Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay.

DESIGN: Prospective, descriptive.

METHODS: Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate.

RESULTS: Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size <28 French, and when both mediastinal and pleural tubes were present (all p<0.001). In the first 4-hours, time spent on chest tubes was higher when patients had previous cardiac surgeries (p≤0.002), heart failure (p<0.001), preoperative anticoagulant medications (p=0.031) and reoperation for postoperative bleeding/tamponade (p=0.005).

CONCLUSIONS: Time to manage chest tubes can be anticipated by patient characteristics. Nurse comfort with chest tube-related tasks affected time spent on chest tube management.