Standardize Postoperative Vascular Care and Decrease Length Of Stay Using Collaboration and Communication

Project Topic:

Standardized Postoperative Vascular Care

Hospital, City and State:

Nebraska Methodist Hospital, Omaha, Nebraska

Unit:

• 4 North Progressive Care Unit – Cardiac/Thoracic/Vascular

CSI Participants:

• Ariana Castanon, BSN, RN
• Sarah Holcomb, BSN, RN, GERO-BC
• Ashley Hunter, BSN, RN, PCCN
• Ciera Krzyzanowski, MSN, RN, PCCN

Project Goals/Objectives:

1. Achieve 75% Nursing Compliance with ERAS Protocol
2. Decrease hospital length of stay by 1 day (15.34%)
3. Increase reported nurse confidence in vascular discharge planning
4. Increase Health Work Environment Assessment Tool (HWEAT) True Collaboration and Skilled Communication by 25%
5. Decrease Oldenburg Burnout Inventory by 20%

Project Outcomes:

1. 75.8 % Nursing Compliance with ERAS Protocol
2. Decreased hospital length of stay by 2 days (30.68%)
3. Increase reported nurse confidence in vascular discharge planning
4. HWEAT True Collaboration and Skilled Communication decreased by 2.15%
5. Oldenburg Burnout Inventory decreased by 2.27%

Project Overview:

The 4 North Progressive Care Unit is relatively new to Methodist Hospital, so the team chose to implement a project that would benefit the staff and patients, specifically within the vascular population. During the needs assessment, the team realized there was a lack of a standardized approach to post-operative vascular care, which contributed to a longer length of stay. The unit staff was surveyed to better understand this gap and to assess their confidence in caring for and discharging post-operative vascular surgery patients.

The results of the pre-implementation survey revealed inconsistency in post-operative care practices. In response, the team created a standardized, evidence-based nursing care plan aligned with best practice guidelines for post-operative vascular patients. Baseline data collected included the average length of stay and the associated costs for lower extremity reperfusion surgeries from September 2024 to March 2025 and later compared to post implementation data from September 2025 to March 2026.

Midway through the project, staff provided feedback and the team revised the nursing care plan to improve clarity and usability. These revisions led to increased staff engagement, participation and overall utilization of the standardized care plan.

Following implementation of the standardized care plan, several key outcomes were observed. Nursing compliance with the ERAS protocol reached 75.8%, demonstrating strong utilization of the evidence-based approach in daily practice. The average hospital length of stay decreased by 2 days or 30.68% reduction compared to baseline. Nurses reported increased confidence in post-operative care as evidence by survey results. Though there was a decrease in HWEAT True Collaboration and Communication (2.15%) and Oldenburg Burnout Inventory scores (2.27%), the overall findings suggest meaningful improvements in care standardization and nursing practice.