CARDIAC SURGERY PEDIATRIC DISCHARGE: THE IMPORTANCE OF THE LENGTH OF STAY

Proper discharge planning is crucial for preventing postoperative complications, reducing readmissions, and enhancing the quality of life for patients and their families. In pediatric cardiac surgery, discharge marks a critical transition from hospital to home, requiring careful attention to ensure care continuity and safety. Despite its importance, nurse-led discharge programs remain underdeveloped, with inconsistent terminology and non-unique definitions in the literature. This clinical quality improvement project aims to identify factors leading to the activation of a nurse-led discharge plan for pediatric cardiac surgery patients to improve the discharge process. Methods involved retrospective audits of 300 clinical records from 2023 to mid-2024, analyzing the use of a nurse discharge letter based on the Cantarelli model, employed in the pediatric cardiac surgery unit since 2008. Among 300 patients, 235 did not receive a discharge nursing letter, with language barriers accounting for 99 cases. Sixty-four patients received the nurse discharge letters, which include suggestions about the surgical area hygiene (n=60), wound care (n=57), and movement (n=56). A significant association (p=0.040) was found between length of stay (LOS) and the likelihood of receiving a nurse discharge letter. Patients with LOS > 16 days were less likely to receive a letter, while those with LOS < 11.5 days were more likely to receive one. These findings suggest that longer hospital stays may provide sufficient time for education on care management, reducing the need for formal discharge instructions. Despite limitations, understanding patient needs is essential for developing effective future care plans.