The intensive care unit (ICU) nurse’s role in reducing complications after cardiac surgery: An integrative review

Introduction: Perioperative nursing begins at the start of a surgical admission and continues until patient discharge, thus encompassing nursing care provided in the intensive care unit (ICU). Cardiac surgery is associated with high rates of post-operative complications that significantly increase mortality, morbidity and length of hospital stay. Many of these complications occur early in the post-operative period within the ICU, where nurses are central to monitoring, prevention and timely intervention. Despite this, nursing contributions are often under-represented in the literature compared with medical or surgical perspectives.This integrative review investigated the common post-operative complications following cardiac surgery and the role of ICU nurses in reducing the risk of such complications.Methods: A comprehensive search was conducted across Scopus, HealthSource: Nursing/Academic Edition, CINAHL and MEDLINE. Studies published in English within the last five years were included if they focused on the nursing role in the ICU following cardiac surgery. A total of 26 studies met the inclusion criteria and methodological quality was appraised using appropriate EQUATOR Network tools.Findings: Four key themes emerged: respiratory complications, cardiovascular complications, acute kidney injury and post-operative delirium. Evidence highlighted that vigilant monitoring, structured assessment protocols, pre-operative education, early mobilisation, advocacy for pharmacological interventions and family involvement are pivotal nursing strategies that improve outcomes. However, limited standardisation of protocols and inconsistent implementation were noted across studies, possibly reflecting gaps in the literature rather than clinical practice.Conclusion: Intensive care unit nurses play a critical role in the early post-operative phase following cardiac surgery. Nurse-led, evidence-based interventions can significantly reduce the incidence of post-operative complications, improve recovery and enhance survival. Further multicentre, nursing-focused research is needed to validate interventions, strengthen implementation strategies and develop standardised guidelines for practice.