CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
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AFRICA
Results:
There were 4 368 cardiac surgical patients discharged from
PICU during this six-and-a-half-year period. Of these, 197 (4.5%)
were readmitted. The most common cause for readmission was respir-
atory dysfunction, primarily resulting from effusions, infection or
upper airway obstruction. The second highest cause was cardiovascu-
lar dysfunction, predominantly sepsis, cardiac failure or arrhythmias.
Conclusions:
Respiratory complications were the most common
cause for early PICU readmission among paediatric cardiac patients.
Further development of the subjective/objective score components
specific to this patient group will improve discharge planning and
avoid readmission to the PICU.
1659: ACADEMY OF CARDIOVASCULAR EXCELLENCE:
DEVELOPMENT OF A CARDIAC CURRICULUM FOR
PROFESSIONAL DEVELOPMENT OF STAFF IN A PAEDI-
ATRIC ACUTE-CARE HOSPITAL SETTING
Kas Sheehan
1
, Susan Collins
2
1
All Children’s Hospital, St Petersburg, Florida, USA
2
All Children’s Hospital, St Petersburg, Florida, USA
Background:
Caring for patients with congenital heart disease
poses many challenges that may impact on clinical performance,
productivity, patient safety and outcomes. These challenges are
constantly changing due to many factors, such as staff turnover and
skills mix, continued technological advances in care, and increas-
ing complexity of children and adults presenting with paediatric
cardiovascular disease. We determined the need for a standardised
cardiac educational programme that could be offered to all staff on
an on-going basis, providing an opportunity for continued develop-
ment of the knowledge and critical thinking skills necessary to meet
these challenges. The Academy of Cardiovascular Excellence (ACE)
was developed.
Methods:
In 2008, a multidisciplinary group with representatives
from the cardiovascular ICU, cardiac catheterisation laboratory,
cardiac operating room and non-invasive cardiology in a paediatric
acute-care hospital met frequently to discuss the development of this
programme. Discussion centred around the core knowledge-based
objectives that were felt to be essential in providing care to this
patient population along the continuum of care, encompassing all of
these clinical areas.
Results:
A 48-hour core curriculum was developed and offered over
an eight-week period, six hours each week, at a minimum of three
times per year. Didactic sessions, group discussion and case-based
scenarios promoting critical thinking allowed for the application
of content to the participant’s specific practice area. An 18-hour
advanced curriculum, offered in three sessions of six hours each,
enhanced the core knowledge provided in the curriculum.
Conclusions:
Course evaluations have indicated a high level of
satisfaction with the content and delivery of the ACE programme as
well as providing feedback related to opportunities for improvement
in the course content since its inception. The programme continues
and is evolving further to meet the changing needs of the patient care
environment.
1714: NEONATAL SCREENINGWITH PULSE OXIMETRY IN
10 858 NEONATES: MULTICENTRE PROJECT IN NORTH-
EAST BRAZIL
Carolina Paim Gomes De Freitas, Sandra da Silva Mattos, Felipe
Alves Mourato, Renata Grigorio Silva Gomes, Kelline Pereira
Coelho, Aniele Bandeira Paiva, Luana Monteiro Lima, Cacera Rocha
dos Santos, Maria da Guia Acioly, Jacinta Tavares Vieira
Carculo do Corao de Pernambuco, Pernambuco, Brazil
Introduction:
Congenital heart disease accounts for approximately
nine in every 1 000 neonates. Early diagnosis and treatment is needed
in about one-third of the cases. When optimised, the arterial pulse
oximetry test (POT) adds to physical examination as a low-cost and
efficient screening tool.
Objective:
To report the results from arterial pulse oximetry and
physical examination with a telemedicine network established
between two states in north-east Brazil.
Methods:
This was a multicentre, descriptive, prospective study
from 12 centres between January and July 2012. Nursing teams from
all centres were trained to collect data and input in a database. POT
was considered normal when two examinations from the right arm
and one foot had SpO
2
>
95% and the difference between them was
below 2%. Physical examination focused on the presence of murmurs
and examination of peripheral pulses. Neonates with abnormal
physical examinations or POT were referred to a neonatal screening
echocardiogram.
Results:
A total of 10 858 POT were performed; 554 were abnormal
and 214 babies were referred to a screening echo performed by a
neonatologist under cardiological supervision. There were 138 abnor-
malities detected. The relationship between abnormal POT/collected
POT decreased from 14.8% in January to 3% in July. The number of
echoes performed was below the number of abnormal POTs except
in July.
Conclusion:
Neonatal screening for CHD in the state of Paraiba
started this year and has already evaluated over 10 000 neonates.
The fall in abnormal POTs in recent months reflects a learning curve
with the test. Isolated, POT accounted for the detection of 15.5% of
CHD, the remaining cases being screened by physical examination
alone (81.2%) or physical examination and POT (3.3%). The POT
test is easy to perform but requires training and the establishment
of routines to be reliable. Physical examination remains the most
important tool for screening for CHD.
1780: FACTORS INFLENCING MEANING OF LIFE IN
ADOLESCENTS WITH CONGENITAL HEART DISEASE
Ju Ryoung Moon, June Huh, I-Seok Kang, Tae-Gook Jun, Heung
Jae Lee
GUCH Clinic, Cardiac and Vascular Centre, Samsung Medical
Centre, Seoul, Korea
Purpose
: This study was designed to identify variables associated
with meaning of life in adolescents who underwent cardiac surgery
for congenital heart disease (CHD).
Methods
: Data were collected from 120 adolescents with CHD, aged
15 to 18 years, during out-patient clinic follow up after open-heart
surgery in one major cardiac centre in Korea. Adolescents completed
measures of meaning of life, self-esteem, self-control, parental
attitude, family satisfaction, school adjustment and career maturity.
Their New York Heart Association functional class and non-invasive
saturation of arterial oxygen were also measured.
Result
: The mean total score for the meaning of life scales was 2.05
points, which was slightly low. There was a significant relation-
ship between meaning of life and self-esteem, self-control, parental
attitude, family satisfaction, school adjustment, career maturity and
functional class. The multiple regression analysis also showed that
53% of the variance in meaning of life in adolescents with CHD
could be explained by self-esteem, family satisfaction, school adjust-
ment, parental attitude and functional class.
Conclusion
: These results indicate a need to develop nursing inter-
ventions to increase self-esteem, family satisfaction, school adjust-
ment, parental attitude and functional class in order to improve
meaning of life for adolescents with CHD.
1797: SEVERE LEFT VENTRICULAR COMPACTION IN
EARLY CHILDHOOD
Ruth Burrage, Nitha Naqvi
Royal Brompton Hospital, London, UK
Background:
Left ventricular non-compaction is characterised by
hyper-trabeculated myocardium. There are deep recesses communi-
cating with the left ventricular chamber, where blood penetrates, with
the risk of clots developing. Adult prevalence is estimated at 50 per
