Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Katherine Moran, DNP, RN

Second Advisor

Sandra Spoelstra, PhD, RN

Third Advisor

Denise Busman, MSN, RN


The transfusion of blood products can lead to life-threatening complications after surgery. In addition, blood products are a scarce and expensive resource. Even though anemia in coronary artery bypass surgery patients is currently undertreated, research has shown that the intravenous infusion of iron products, as well as a single dose of erythropoietin-alpha prior to surgery, decreases the amount of blood products used in the perioperative setting. The goal of this pilot project was to increase the number of patients screened for anemia, and if necessary, treated prior to coronary artery bypass graft surgery.

Methods: This was a practice improvement, pilot project within a preoperative assessment center in a large Midwestern health system. The population included outpatient coronary artery bypass graft surgical patients. The presence of anemia was determined prior to the required cardiac catheterization before coronary artery bypass graft surgery. Through a new process, patients diagnosed with anemia were referred to the preoperative assessment center for optimization and treatment management. The results of this quality improvement project showed an increase in the number of patients who received treatment for their anemia prior to surgery.

Conclusions: The literature suggests that a decreased use of blood products will result in fewer complications following cardiac surgery. While this pilot project did not show a statistical difference in the amount of blood products used, there was a clinically meaningful improvement as the new process for anemia management increased the number of patients treated for anemia prior to surgery.

Implications: This new referral process was successful in treating preoperative anemia. Continued improvement in the treatment of anemia is needed to decrease the number of postsurgical complications that may arise from anemia in this population of coronary artery bypass graft patients.