NURSING INSERVICE NOTES — HEART HUGGER

We recommend that inservice attendees watch the seven-minute “Nursing Inservice & Patient Education” videotape at the beginning of the inservice and practice applying and using Heart Hugger on each other during the inservice. If possible, have your patient watch the video with their significant other(s) prior to surgery—this can make a big difference in compliance.

Some points to be covered in the inservice.

  1. Heart Hugger is usually applied to the patient soon after they are extubated. The patient must be supported to sit forward in bed to get fit and adjust Heart Hugger.
  2. Patients cannot move their arms much. The shoulder straps are fitted with side release buckles (not shown in the video) to make it easier to fit the patient and to get around any lines.
  3. The most common problem with fitting Heart Hugger is adjusting the handles too closely together. Make sure they’re far enough apart so that when the patient squeezes them together, the chest belt tightens up enough to provide support.
  4. The most typical complaint is that as the patient slides down in bed, Heart Hugger rides up the patient’s back, causing the handles to fall below the patient’s sternum. When the patient is readjusted in bed, Heart Hugger should be pulled down in back to reposition the handles correctly at about the patient’s nipple line for Men, and above the breasts for women.
  5. Remember to advise the patient to use “fingertips only” when using Heart Hugger. The handles are designed to accommodate the fingertips. Placing the hand completely through the handle risks disturbing the sternal wound.
  6. As the patient gets stronger and more mobile following surgery, the handles can be adjusted further apart to provide more support when squeezed together.
  7. Heart Hugger is usually readjusted to fit over the patient’s street clothes at discharge and continues to be worn from up to six weeks post-discharge.
  8. While principally used by the patient, Heart Hugger is useful to their care providers by providing them with handles to help readjust the patient in bed and to help the patient in sitting up or getting into and out of beds and chairs.
  9. Simple fitting and adjustment instructions are located on the Heart Hugger itself.

Some points to be aware of when applying Heart Hugger to Thoracotomy patients:

  1. Heart Hugger is usually applied to the patient soon after they are extubated in the ICU. The patient must be supported while leaning forward to fit and adjust Heart Hugger. If possible, size, fit and adjust Heart Hugger to the Thoracotomy patient preoperatively to avoid unnecessary movements post-op.
  2. Patients should not move their arms much, keeping them close to their body never allowing them to lift elbows above shoulders. The shoulder straps are fitted with side release buckles to make it easier to fit to the patient and to adjust chest and shoulder straps around any lines or drainage tubes.
  3. We suggest placing a small hand towel over the incision between the Heart Hugger chest strap and the patient’s gown. This will allow for an increase in padding over the patient’s incision to prohibit or reduce any rubbing that may occur when patient squeezes handles together.
  4. The most common problem with fitting Heart Hugger is adjusting the handles too closely together. Make sure they’re far enough apart so that when the patient squeezes them together, the chest belt tightens up enough to provide support. Patients should be squeezing handles together anytime they cough, sneeze or move, including being rolled in bed every few hours.
  5. The most typical complaint is that as the patient slides down in bed, Heart Hugger rides up the patient’s back, causing the handles to fall below the patient’s sternum. When the patient is readjusted in bed, Heart Hugger should be pulled down in back to reposition the handles correctly.
  6. Remember to advise the patient to squeeze the handles together using “fingertips only” when using Heart Hugger. The handles are designed to accommodate the fingertips.
  7. As the patient gets stronger and more mobile following surgery, the handles can be adjusted further apart to provide more support when squeezed together. Heart Hugger is usually readjusted to fit over the patient’s street clothes at discharge and continues to be worn from two to four weeks post-discharge.