The effect of an open-heart surgery patient care protocol on post-sternotomy pain, anxiety and quality of care: A randomized controlled trial.

The protocol was developed only for a cardiac surgical intensive care unit and tested there, so it may not apply to other units or patients. The study did not follow patients after transfer from intensive care to the clinic, so effects after ICU discharge are unknown. The time between surgery and extubation was not included, which may affect early pain and anxiety findings. The intervention was a bundle of many nursing actions, so the contribution of any single component cannot be separated. The supplied text reports within-group anxiety decreases but does not report a between-group anxiety test, so the anxiety effect relative to routine care is not established. Pre-test anxiety means differed between groups, 39.28 in the protocol group and 58.03 in the control group, and the paper does not report a test of that baseline difference.

The authors declared no potential conflicts of interest. The supplied text does not name a funder.

Do not conclude that one nursing action caused the pain or anxiety reduction. The protocol bundled patient delivery, visits, tests, evaluation and diagnostic procedures, medication administration, pain management, treatment and clinical procedures, nursing interventions, psychosocial support, hydration and nutrition, activity and environmental safety, patient information, service transfer planning, and evaluation, and the study does not separate their effects. Do not read the anxiety result as proof of lower anxiety than routine care, because the supplied text reports anxiety decreases within both groups but no between-group anxiety test.