Intensive care nurses' conceptions of a critical pathway in caring for aortic-surgery patients: a phenomenographic study.

The aim of the present study was to identify and describe intensive care nurses' different conceptions of a critical pathway in caring for patients that have undergone aortic-surgery. Individual semi-structured interviews with eight specialist registered nurses at a Swedish intensive care unit were conducted and phenomenographically analysed. Three descriptive categories, with a total of five sub-categories, constituted the outcome-space of how the pathway was conceived of in caring: as a guide open to individual patients needs (clinical judgement governs caring and patient autonomy governs caring), as an instrument to promote patient safety (a source of knowledge, a planning tool and a reference standard) and as a source of support for professional confidence. In accordance with current literature, the nurses in the present study identified a number of advantages in applying the pathway in caring even if they were also conscious that the use of a pathway can give rise to unreflective standardisation. The nurses' conceptions indicate that the pathway prescribed for managing patients who have undergone aortic surgery is supportive and facilitates patient safety without jeopardising respect for the patient's individual care needs. This insight may be used to influence a thoughtful dialogue about the practice of pathways in intensive care.

Atherosclerotic occlusive disease of the aorta.

Aortoiliac occlusive disease is a common manifestation of atherosclerosis. Signs and symptoms include intermittent claudication, diminished femoral pulses, and impotence in males. During the assessment process, the coronary, renal, cerebrovascular, and distal extremity vessels must also be evaluated. Treatment options include conservative measures including angioplasty, as well as surgical intervention including aortic reconstruction or extra-anatomic bypass surgery.