Running head: CARDIAC SURGERY TERMINOLOGY DOMAIN

Complications Following Emergent CABG:

Cardiac surgery Terminology Domain

Ken Bavier BSN, RN

Duke University School of Nursing

N409

Instructor: Dr. Linda Goodwin

Deb Molstad

I selected as my terminology domain, cardiac surgery of which I am very familiar, and that is attributed to the primary cause of death for Americans (American Heart Association, 2005 & American College of Cardiology, 2005). My one-page story described a patient situation where the patient developed an unusual complication post operatively that nearly led to the loss of his life. As I iterated over the domain terminology, I moved away from the focus of this patientÕs complication, and instead focused on normal patient evolutions and more common complications. The volume of terms that were revealed during the iterative phase was significant, and ultimately exceeded 400 items. This list is in no way exhaustive, but rather serves as a foundation for further review.

The cardiac surgery terminology domain borrows terms from many disciplines including cardiology, nursing, anesthesia, psychology, anatomy, and surgery. Compound terms are common, owing to the complexity of the patient and the treatments that they undergo. Current leadership in the develpoment of cardiac surgery and cardiology specific terminologies include the American College of Cardiology, the American NursesÕ Association, the Association of Operating Room Nurses, and the American Heart Association.

High level concepts noted in the development of this project included such areas as risk factors, symptoms, treatments, clinical services, environmental factors, diagnostics, anatomy and physiology, and complications. The organization of this domain could have been arranged differently to include a separate section covering equipment and pathophysiology though the current organizational schema developed logically from my early term list.

It is significant to note that the treatments, anatomy and physiology, and complications subsections could have included exponentially more terms though the more terms I added, the more it seemed like I was leaving the realm of cardiac surgery. The final term list was redundant with some of the earlier terms but contained such a significant number that I included it in itsÕ entirety next to the original lists rather than try to include the 300+ terms that developed during the brainstorming sessions with the mindmapping software. The folowing Excel chart reflects the evolution of the cardiac domain terminology project:

Meaningful Story Term	Additional Terms	Patient	Nurse	Physician	Subject Matter Expert Suggestions	Final Results Imported from MindManager
					Paramedic	Treatments
Intensive Care		X	X	X	Surgeon	Counseling
Post-op			X	X	Critical Care	Clinical
Surgery		X	X	X	Pulmonologist	Religious
Cardiac			X	X	Intensivist	Social Work
Patients		X	X	X	Ambulance	Medications
Complicated			X	X	EMT	Antiarrythmics
Emergently/Emergent			X	X	Visiting Hours	Cardizem
Nurse		X	X	X	Limited	Lidocaine
Recovery/Recovering		X	X	X	Generous	Adenosine
ER		X	X	X	Restricted	Cardioversion
Chest Pain		X	X	X	discretion	Countershock
MI			X	X	Stepdown	Anticoagulants
Crushing		X	X	X	Telemetry	Coumadin
Pressure		X	X	X	Cath Lab	Hirudin
Radiating			X	X	Operating Room	Heparin
EMS			X		OR	Plavix
EKG		X	X	X	Home	Ticlid
ST-Segment Elevation			X	X	Complications	Aspirin
Ectopic Beats			X	X	ER	ASA
Blood Pressure		X	X	X	CCU	Beta Blockers
Heparin			X	X	discharge	Lopressor
Dopamine			X	X	home	Esmolol
Nitroglycerine		X	X	X	rehab	Coreg
Cath lab			X	X	case manager	Tenormin
Coronary angiography				X	CCU Nurse	Calcium Channel Blockers
Heart cath		X	X		circulator	Cardizem
Triple vessel disease			X	X	ER Nurse	Norvasc
CABG			X	X	floor nurse	Procardia
Invasive line