Nursing Department, Cardiovascular Surgery HSCU, Head Nurse Zheng Anyun, Assistant Head Nurse Wang Peiju.
Due to inconvenient transportation, sparse and dispersed populations, medical resources are generally lacking in rural and remote island areas. Take Penghu as an example: it consists of 90 small islands, most of which rely on ferries for connectivity. The unique demographic structure of Penghu shows that 19% of the population is aged 65 and older, many of them live alone or are elderly couples taking care each other. Additionally, a shortage of medical personnel (due to population outflow) and low trust in medical services exacerbate the healthcare system.
The cardiovascular surgery team of Tri-Service General Hospital (TSGH) utilities the ESG concept to focus on reducing resource consumption and environmental pollution caused by transportation , and promote "local healthcare" policy for outlying islands. Guided by the Military Medical Bureau's policy of "the patient stays, the medical team moves," we launched the "Heart Guardian Angel Replication Program" to operate high-quality cardiovascular surgical services to Penghu.
Recently, the Penghu branch of TSGH admitted a 54-year-old Mr. Chen, who has been smoking for nearly 30 years. He sought medical attention due to chest tightness and pain. The examinations revealed severe aortic valve stenosis and significant calcification. After assessment by cardiac surgeon Dr. Zheng Xuzhi, it was necessary to operate an aortic valve replacement surgery for the patient. Considering family factors, Mr. Chen proactively requested to stay in Penghu for the procedure. The Penghu branch immediately began related medical support operations, with the lead from TSGH’s medical team conducting the inter-island Heart Guardian Angel Replication Program. TSGH’s cardiovascular surgery team successfully completed the surgery through knowledge transfer and practical experience , and guided the Penghu branch of TSGH in providing comprehensive perioperative and postoperative intensive care, rehabilitation, and discharge preparation.
Head Nurse Zheng Anyu of TSGH’s cardiovascular intensive care unit noted that perioperative care and postoperative intensive care for cardiac surgery are complex and heavily rely on the teamwork of specialized medical personnel. Besides the surgical difficulties, postoperative care requires close monitoring of vital signs such as blood pressure and heart rhythm, while minimizing bleeding risks and preventing complications like cardiac tamponade and coronary artery obstruction. Moreover, due to the severe calcification of Mr. Chen's aortic valve, the surgery carried a higher risk of stroke than usual, necessitating continuous monitoring of the patient's consciousness and limb strength. Under nursing guidance, early cardiopulmonary rehabilitation exercises were initiated for preventing delirium and muscle weakness. Mr. Chen was able to get out of bed on the second day post-surgery and was transferred from the intensive care unit to a general ward on the fourth day, successfully discharged on the twelfth day post-surgery. Mr. Chen expressed deep gratitude to the nursing staff and medical team for their encouragement and assistance, and filled with hope for his future quality of life.
In 2023, TSGH’s cardiovascular department had performed nearly 500 surgeries, and the Heart Guardian Angel training program for "ventricular assist device care procedures" has earned the SNQ National Quality Mark certification. We have successfully replicated essential cardiac and vascular surgeries (such as coronary artery bypass surgery, ECMO placement/replacement/removal surgeries, and valve surgeries) at the Penghu branch of TSGH, and trained more nurses with specialized cardiovascular skills. Through telemedicine, professional certification courses, and rotational support, we aim to bring these skills to rural areas.
The "Heart Guardian Angel Replication Program" is involved with one-by-one guidance from senior experienced nurses, through a phased approach to theoretical and practical learning. This enables trained healthcare personnels to gradually become independent cardiovascular nursing experts. By replicating a high-quality intensive care team, we can effectively narrow the medical gap between urban and rural regions, enhance local healthcare manpower, and truly serve as a blessing for the residents of rural regions.