Situation-specific theory of surgical site infection-related stimuli in patients undergoing heart transplantation

Abstract

Background and objective: Heart transplant is a life-saving treatment and currently is the definitive gold-standard in the treatment of refractory heart failure. Surgical site infection is a serious complication of heart transplantation. A nursing theory predicting consequences related to the management of risk factors for surgical site infection in patients undergoing heart transplantation can be useful to nursing practice. The objective of this study was to develop a situation-specific theory of surgical site infection-related stimuli in patients undergoing heart transplantation.

Methods: It was adopted an integrative strategy to develop the theory. Multiple sources of knowledge were accessed. The Roy Adaptation Model was adopted as the foundation for the development of this situation-specific theory in a nursing perspective. A literature review on risk factors for surgical site infection in patients undergoing heart transplantation was conducted. By configuring those sources with practice expertise in a collaborative effort, risk factors for surgical site infection in patients undergoing heart transplantation were classified as contextual or residual stimuli, focal stimulus was defined, and seven theory propositions were developed.

Results: Heart transplant surgery was considered as focal stimulus. The contextual stimuli were classified as preoperative, intraoperative, and postoperative contextual stimuli. The residual stimuli were classified as preoperative and intraoperative residual stimuli. No postoperative residual stimulus was identified. Ten theory propositions were created.

Conclusions: The emerging theory can help nurses to prevent surgical site infections in patients undergoing heart transplantation. Further developments must be made in order to consider nurse-patient interactions during the prevention of surgical site infections.