Date of this Version


Document Type

DNP Project



Surgical correction for the chest wall deformity known as Pectus Excavatum (PE) is often performed during adolescence for patients exhibiting cardiac, respiratory, and psychological problems. The established surgery performed to correct PE is a thoracoscopic-assisted minimally invasive repair of pectus excavatum (MIRPE) or Nuss procedure. The clinical care of patients who undergo the Nuss procedure is mainly focused on the postoperative pain management related to the constant pressure from the bar(s) on the sternum. A quality improvement project was developed with the aim to improve the nurses’ knowledge of the postoperative care for the pediatric patient undergoing a Nuss procedure. The project was set in a stand-alone urban pediatric hospital. Participants included pediatric nurses who work in the surgical unit and nurse practitioners who manage pediatric surgical patients.

A comprehensive study search was conducted using CINAHL and MEDLINE (ProQuest) to identify research studies from the past five years that have evaluated the effectiveness of the nurses’ knowledge of postoperative care for patients undergoing chest wall corrective surgery. The six research studies identified as relevant for review investigated nurse’s knowledge and attitudes of postoperative pain management in the pediatric patient and the effectiveness of enhanced recovery pathways to improve patient outcomes. The quality improvement project demonstrated that the implementation of a targeted education program for the care of the pediatric patient who undergoes a Nuss procedure improved the clinician’s knowledge and attitudes that positively impact pain management practices and improve patient outcomes.