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Clinical Nurse Specialist–Led Implementation of an Early Discharge Protocol After Cardiac Surgery

Kwak, Chanyeong, PhD, CNS; Ko, Young, PhD, RN

doi: 10.1097/NUR.0000000000000457
Feature Article

Purpose/Aims Current practice in Korean medical institutions executes prolonged average length of stay post–cardiac surgery, imposing higher risks of mortality and morbidity, along with administrative issues resulting in long waiting lists for future cardiac surgery. The purpose of this article is to develop and evaluate an early discharge protocol after cardiac surgery led by clinical nurse specialist in a Korean medical institution.

Description of the Project/Program The project of implementing early discharge protocol seeks to provide an efficient delivery system for patients who are undergoing cardiac surgery. To evaluate the efficacy of this project, a group of cohorts administered with early discharge protocol was compared against the control group for their length of hospital stay, adverse complications, and clinical outcomes such as postoperative mortality and morbidity.

Outcomes The early discharge protocol group had a decreased hospital length of stay by 30% (P < .05) compared with the control group under the conventional discharge protocol while maintaining patient safety and minimizing exposure of patients to further risks of mortality and morbidity.

Conclusion Clinical nurse specialist–led early discharge protocol in patients who received cardiac surgery decreases length of stay, thus minimizing exposure of patients to further risks of mortality and morbidity.

Author Affiliations: Professor (Dr Kwak), School of Nursing, Hallym University, Chuncheon, South Korea; and Associate Professor (Dr Ko), College of Nursing, Gachon University, Incheon, South Korea.

This study was supported by the faculty research support grant of the Hallym University.

The authors report no conflicts of interest.

Author Contributions: C.K. was responsible for the establishment of conceptual framework and designing randomized clinical trial. C.K. supervised and supported whole process of the clinical trial and communicate with clinical nurse specialists. Y.K. was in charge of data collection, coding, data analysis, and preparing for a preliminary draft. C.K. and Y.K. collaborated in working for the manuscript completion.

Correspondence: Young Ko, PhD, RN, College of Nursing, Gachon University, 191 Hambakmoeiro, Yeonsu-Gu, Incheon, Korea 21936 (

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