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Kurt Y, Kaşıkçı M. The effect of the application of cold on hematoma, ecchymosis, and pain at the catheter site in patients undergoing percutaneous coronary intervention. Int J Nurs Sci 2019; 6:378-384. [PMID: 31728389 PMCID: PMC6838915 DOI: 10.1016/j.ijnss.2019.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/13/2019] [Accepted: 09/05/2019] [Indexed: 12/04/2022] Open
Abstract
Objective This study was conducted to determine the effect of the application of cold on hematoma, ecchymosis, and pain in patients undergoing percutaneous coronary intervention. Methods It is a quasi-experimental study with a control group. A total of 200 patients (100 in the control group and 100 in the experimental group) were included in the research. In the experimental group, a cold pack was applied to the bottom of the sandbag for the first 15 min after withdrawing the femoral arterial catheter. Both groups were assessed and followed up at the first 15th minute and 4th, 48th and 72 nd h. Results After the femoral arterial catheter was withdrawn, ecchymosis and hematoma were smaller and pain was less in the experimental group at the catheter entry site compared to the control group, and the difference was statistically significant (P < 0.01). Conclusion It was determined that the application of cold reduced the formation of hematomas, ecchymoses and pain in patients after the withdrawal of the femoral arterial catheter.
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Affiliation(s)
- Yeter Kurt
- Fundamentals and Management of Nursing Department, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
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Al-Momani MS, AbuRuz ME. Incidence and predictors of groin complications early after coronary artery intervention: a prospective observational study. BMC Nurs 2019; 18:24. [PMID: 31297032 PMCID: PMC6599377 DOI: 10.1186/s12912-019-0349-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/20/2019] [Indexed: 12/12/2022] Open
Abstract
Background Coronary artery disease remains the most common single cause of death worldwide. Percutaneous coronary intervention is an appropriate management for coronary artery disease which is not free from its potential complications. The purpose of this study was to determine the incidence rate and the predictors of groin complications post percutaneous coronary intervention in cardiac catheterization laboratories in Jordan. Methods This was a prospective observational study with a consecutive sample of 300 patients post percutaneous coronary intervention procedure. Data were collected from the cardiac health care center using a pre-structured observational sheet. Any groin complication developed within the first 24 h post procedure was recorded. All correlated variables were analyzed using logistic regression. Results The sample included 237 (79%) men and 63 (21%) women with a mean age of 57.46 ± 10.51 years. A total of 114 patients (38%) developed one or more groin complications. Ecchymosis was the most frequent groin complication; 102 (34%). Females and participants greater than 65 years were nearly two times more likely to develop groin complications (OR = 2.13, P = .024, 95% CI: 1.11-4.01) and (OR = 2.14, P = .023, 95% CI: 1.11-4.13) compared to other groups. Patients with a systolic blood pressure before sheath removal greater than 180 mmHg were about ten times more likely to develop groin complications (OR = 9.82, P = .001, 95% CI: 2.58-37.37). Conclusions Different factors can increase the risk of groin complications post percutaneous coronary intervention. Therefore, identification of high risk groups (i.e. females) might help in the application of different methods to control these complications.
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Affiliation(s)
| | - Mohannad Eid AbuRuz
- 2Applied Science Private University, Po box 142 Shafa Badran, Amman, 11934 Jordan
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Romero PS, Costanzi AP, Hirakata VN, Beghetto MG, Sauer JM, Rabelo-Silva ER. Subsample analysis of the Vascular Complications Risk Score at two public referral centers for interventional cardiology. Rev Esc Enferm USP 2019; 53:e03438. [PMID: 31215613 DOI: 10.1590/s1980-220x2018005103438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/20/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate the performance of the Vascular Complications Risk Score in two public referral centers for interventional cardiology. METHOD Subsample analysis of the Vascular Complications Risk Score, which was developed and validated in the catheterization laboratories of three cardiology referral centers (two public, one private) with a cutoff of <3 for no risk of developing vascular complications and ≥3 for risk. In this new analysis, we excluded data from the private facility, and only included participants from the original (validation) cohort of the two public hospitals. RESULTS Among the 629 patients studied, 11.8% had vascular complications; of these, 1.8% were major and 10% minor. Among the patients with a score <3, 310 (94.5%) presented no vascular complications; of those with a score ≥3, 50 (17%) developed complications. Of those who developed vascular complications, 18 scored <3; two of these had major complications. CONCLUSION This subanalysis confirms the ability of the Vascular Complications Risk core to predict low risk of vascular complications in patients with a score < 3.
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Affiliation(s)
- Paola Severo Romero
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Divisão de Cardiologia, Porto Alegre, RS, Brazil
| | - Angelita Paganin Costanzi
- Hospital Unimed, Caxias do Sul, RS, Brazil.,Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Vânia Naomi Hirakata
- Hospital de Clínicas de Porto Alegre, Divisão de Cardiologia, Porto Alegre, RS, Brazil
| | - Mariur Gomes Beghetto
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Jaquelini Messer Sauer
- Fundação Universitária de Cardiologia, Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eneida Rejane Rabelo-Silva
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Divisão de Cardiologia, Porto Alegre, RS, Brazil
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Paganin AC, Beghetto MG, Feijó MK, Matte R, Sauer JM, Rabelo-Silva ER. Vascular complications in patients who underwent endovascular cardiac procedures: multicenter cohort study. Rev Lat Am Enfermagem 2018; 26:e3060. [PMID: 30328978 PMCID: PMC6190486 DOI: 10.1590/1518-8345.2672.3060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/01/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE to analyze vascular complications among patients who underwent endovascular cardiac procedures in the hemodynamic laboratories of three referral centers. METHOD a multicenter cohort study was conducted in three referral facilities. The sample was composed of 2,696 adult patients who had undergone elective or urgent percutaneous cardiac procedures. The outcomes were vascular complications, such as: hematoma at the site of the arterial puncture; major or minor bleeding; surgical correction for retroperitoneal hemorrhage; pseudoaneurysm; and arteriovenous fistula. RESULTS 237 (8.8%) of the 2,696 patients presented a vascular complication at the site of the arterial puncture. The total number of vascular complications was 264: minor hematoma<10cm (n=135); stable bleeding (n=86); major hematoma ≥10cm (n=32); and unstable bleeding (n=11). There were no retroperitoneal hematoma events, pseudoaneurysm or arterial venous fistula. Most of the major and minor complications occurred in the first six hours after the procedure. CONCLUSION the results concerning the current context of interventional cardiology indicate that the complications predominantly occur in the first six hours after the procedure, considering a 48-hour follow-up. The staff should plan and implement preventive measures immediately after the procedures.
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Affiliation(s)
- Angelita Costanzi Paganin
- Unimed, Laboratório de Hemodinâmica, Caxias do Sul, RS, Brazil
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Mariur Gomes Beghetto
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Maria Karolina Feijó
- Prefeitura Municipal de Porto Alegre, Secretaria Municipal de Saúde, Porto Alegre, RS, Brazil
| | - Roselene Matte
- Hospital de Clínicas de Porto Alegre, Unidade de Hemodinâmica, Porto Alegre, RS, Brazil
| | | | - Eneida Rejane Rabelo-Silva
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Unidade de Hemodinâmica, Porto Alegre, RS, Brazil
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Effect of changing the duration of keeping sandbag over catheter insertion site on the coronary angiography acute complications: A controlled clinical trial. JOURNAL OF VASCULAR NURSING 2017; 35:193-200. [DOI: 10.1016/j.jvn.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/03/2017] [Accepted: 05/04/2017] [Indexed: 11/22/2022]
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Paganin AC, Beghetto MG, Hirakata VN, Hilário TS, Matte R, Sauer JM, Rabelo-Silva ER. A Vascular Complications Risk (VASCOR) score for patients undergoing invasive cardiac procedures in the catheterization laboratory setting: A prospective cohort study. Eur J Cardiovasc Nurs 2016; 16:409-417. [DOI: 10.1177/1474515116684250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- AC Paganin
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
- Unimed Hospital, Caxias do Sul, Brazil
| | - MG Beghetto
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre, Brazil
| | - VN Hirakata
- Hospital de Clínicas de Porto Alegre, Brazil
| | - TS Hilário
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
| | - R Matte
- Hospital de Clínicas de Porto Alegre, Brazil
| | - JM Sauer
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Brazil
| | - ER Rabelo-Silva
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre, Brazil
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Iskandar S, Atoui M, Rizwan Afzal M, Lavu M, Reddy M, Lakkireddy D. Malignancy Associated Iatrogenic Iliopsoas Abscess -Venous Access Complication From Ablation Procedure. J Atr Fibrillation 2016; 8:1442. [PMID: 27909505 DOI: 10.4022/jafib.1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/10/2022]
Abstract
Iliopsoas abscess is a rare condition with a high rate of mortality and morbidity if left untreated. It can occur from hematogenous or lymphatic spread from distant structures or as a result of contiguous spread from adjacent structures. The disease typically occurs in patients with immunocompromised status and the symptoms can be non-specific.1,2 Generally, infectious complications from venous access during atrial fibrillation (AF) procedure are uncommon, and an iatrogenic iliopsoas abscess from percutaneous cardiac procedures has never been reported. We present the first case of iliopsoas abscess from an ablation procedure.
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Affiliation(s)
- Sandia Iskandar
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS
| | - Moustapha Atoui
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS
| | - Muhammad Rizwan Afzal
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS
| | - Madhav Lavu
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS
| | - Madhu Reddy
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS
| | - Dhanunjaya Lakkireddy
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS
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Pezzi MV, Rabelo-Silva ER, Paganin A, de Souza EN. Nursing Interventions and Outcomes for the Diagnosis of Impaired Tissue Integrity in Patients After Cardiac Catheterization: Survey. Int J Nurs Knowl 2016; 27:215-219. [PMID: 27324174 DOI: 10.1111/2047-3095.12140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 03/08/2016] [Accepted: 03/18/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Determine the outcomes and interventions for patients undergoing cardiac catheterization with nursing diagnosis of impaired tissue integrity. METHODS Survey with e-questionnaires sent for expert nurses in two rounds. FINDINGS Only one nursing outcome was approved: tissue integrity-skin and mucosa and five related interventions, namely, pressure control, topical drug administration, care of incision site, care of injuries, and infection control. CONCLUSIONS The expected outcomes and the most significant interventions for the implementation of nursing care during the immediate recovery of patients with impaired tissue integrity following invasive hemodynamic procedures were defined. IMPLICATIONS FOR NURSING PRACTICE The study findings support selection of appropriate nursing outcomes and interventions for this patient profile.
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Affiliation(s)
| | - Eneida Rejane Rabelo-Silva
- Professor at Cardiovascular Division, Hospital de Clínicas de Porto Alegre, and Nursing School at the Federal University of Rio Grande do Sul, Brasil
| | - Angelita Paganin
- Nurse at Cath Lab at Hospital Unimed Nordeste, Caxias do Sul - RS, Brasil
| | - Emiliane Nogueira de Souza
- Professor at Nursing Department of Federal University of Health Sciences of Porto Alegre, Cardiology Institute of Rio Grande do Sul, Brasil.
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Abdollahi AA, Mehranfard S, Behnampour N, Kordnejad AM. Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial. J Caring Sci 2015; 4:125-34. [PMID: 26171374 DOI: 10.15171/jcs.2015.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 10/12/2014] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. METHODS In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol), early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS) of pain and Kristin Swain's check list was applied to evaluate the severity of bleeding and hematoma. RESULTS None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference. CONCLUSION Based on the findings of this study, changing patients' position can be safe and they can be ambulated early after angiography.
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Affiliation(s)
- Ali Akbar Abdollahi
- Department of Nursing, Ischemic Disorders Research Center, Golestan University of Medical Sciences, Golestan, Iran
| | - Shahzad Mehranfard
- Department of Nursing, Faculty of Nursing & Midwifery, Dezful University of Medical Sciences, Dezful, Iran
| | - Nasser Behnampour
- Department of Biostatistics, Golestan University of Medical Sciences, Golestan, Iran
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Wu PJ, Dai YT, Kao HL, Chang CH, Lou MF. Access site complications following transfemoral coronary procedures: comparison between traditional compression and angioseal vascular closure devices for haemostasis. BMC Cardiovasc Disord 2015; 15:34. [PMID: 25956814 PMCID: PMC4434571 DOI: 10.1186/s12872-015-0022-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 04/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vascular closure devices such as angioseal are used as alternatives to traditional compression haemostasis. Although the safety and efficacy of angioseal are confirmed, their use remains controversial because of the potential complications of these devices compared with those of traditional compression haemostasis. The aim of this study was to compare the access site complication rate, the predictive factors for these complications, and patient comfort levels after coronary procedures with traditional compression or angioseal haemostasis. METHODS Data were collected from a cardiac unit in a medical center in northern Taiwan. A total of 130 adult patients were recruited and equally divided into two groups according to the method of haemostasis used after the coronary procedure: a traditional compression group and an angioseal group. We observed the incidence of access site complications, including bleeding, oozing, haematoma formation, and arteriovenous fistula formation. In addition, we used a 0-10 numeric rating scale to assess soreness, numbness, and back and groin access site pain after 1 h of catheter removal and immediately before getting out of bed. RESULTS The overall incidence of complications was 3.8 % (n = 5), which was not significantly different between the two groups (p = .06). The propensity score--adjusted multivariate analyses revealed that the only independent predictor for access site complications was an age of >70 years (OR, 10.44; 95 % CI, 1.81-60.06; p = .009). Comfort levels were higher in the angioseal group than in the traditional compression group. CONCLUSIONS Angioseal used after coronary procedures did not increase the incidence of complications relative to that associated with traditional compression haemostasis; however, it increased patient comfort levels. Health personnel should pay special attention to the predictive factor for access site complications after coronary procedures, such as age >70 years.
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Affiliation(s)
- Pei-Jung Wu
- Department of Nursing, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road, Taipei City, 11217, Taiwan.
| | - Yu-Tzu Dai
- School of Nursing, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Road, Taipei City, 10063, Taiwan.
| | - Hsien-Li Kao
- Department of Internal Medicine, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Road, Taipei City, 10063, Taiwan. .,Department of Internal Medicine, Division of Cardiology, National Taiwan University Hospital, 7, Chung Shan S. Rd., Taipei City, 10002, Taiwan.
| | - Chin-Hao Chang
- Department of Medicine Research, National Taiwan University Hospital, 7, Chung Shan S. Rd., Taipei City, 10002, Taiwan.
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Road, Taipei City, 10063, Taiwan.
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Discomfort Reported by Patients After Cardiac Catheterization Using the Femoral or Radial Approaches. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s2214-1235(15)30177-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Merriweather N, Sulzbach-Hoke LM. Managing Risk of Complications at Femoral Vascular Access Sites in Percutaneous Coronary Intervention. Crit Care Nurse 2012; 32:16-29; quiz first page after 29. [DOI: 10.4037/ccn2012123] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Percutaneous coronary intervention for acute coronary syndrome or non–ST-elevation myocardial infarction requires the use of potent oral and intravenous anti-platelet and antithrombin medications. Although these potent antithrombotic agents and regimens may increase the effectiveness of percutaneous coronary intervention, they are also generally associated with an increased risk of vascular access complications such as hematoma, retroperitoneal hematoma, pseudoaneurysm, arterial occlusion, and arteriovenous fistula, which in turn are associated with increased morbidity, mortality, and costs. Risk factors predisposing patients to these complications are both modifiable (procedure technique, medications, hemostasis method) and nonmodifiable (sex, age, body mass index, blood pressure, renal function). Patients’ risks can be reduced by nurses who are knowledgeable about these risk factors and identify complications before they become problematic.
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Affiliation(s)
- Nakia Merriweather
- Nakia Merriweather is a cardiology nurse in the echocardiography laboratory at the Hospital of the University of Pennsylvania, Philadelphia
| | - Linda M. Sulzbach-Hoke
- Linda M. Sulzbach-Hoke is a clinical nurse specialist on a 48-bed progressive care unit at the Hospital of the University of Pennsylvania, providing nursing care to adult cardiac patients. Her research and several of her publications support evidence-based nursing practice, specifically in patients undergoing percutaneous coronary intervention
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Strategies for decreasing vascular complications in diagnostic cardiac catheterization patients. Dimens Crit Care Nurs 2012; 31:13-7. [PMID: 22156819 DOI: 10.1097/dcc.0b013e31823a52f5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Vascular complications are the most common type of complication after a cardiac catheterization. These include hematoma, pseudoaneurysm, arteriovenous fistula, peripheral artery occlusion and dissection, and retroperitoneal bleeding. The Pennsylvania Patient Safety Authority reports that nearly half the medical errors that occurred between June 2004 and December 2006 were cardiac catheterization complications, many of which were vascular related. The American College of Cardiology's National Cardiovascular Data Registry benchmark for vascular complications incidence is less than 1% for diagnostic catheterizations and less than 3% for percutaneous coronary intervention. The need to search for strategies to decrease vascular complication in diagnostic cardiac catheterization patients was a priority.
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Burkhoff D, Naidu SS. The science behind percutaneous hemodynamic support: A review and comparison of support strategies. Catheter Cardiovasc Interv 2012; 80:816-29. [PMID: 22431494 DOI: 10.1002/ccd.24421] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 03/10/2012] [Indexed: 12/17/2022]
Affiliation(s)
- Daniel Burkhoff
- Division of Cardiology, Columbia University School of Medicine, New York, New York, USA.
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15
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Rolley JX, Salamonson Y, Wensley C, Dennison CR, Davidson PM. Nursing clinical practice guidelines to improve care for people undergoing percutaneous coronary interventions. Aust Crit Care 2011; 24:18-38. [DOI: 10.1016/j.aucc.2010.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/14/2010] [Accepted: 08/03/2010] [Indexed: 11/26/2022] Open
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Gonzales L, Fields W, McGinty J, Gallo AM. Quality improvement in the catheterization laboratory: redesigning patient flow for improved outcomes. Crit Care Nurse 2010; 30:25-32. [PMID: 20360448 DOI: 10.4037/ccn2010832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Laura Gonzales
- Sharp Chula Vista Medical Center, Chula Vista, California 91991, USA.
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Self-Care Behaviour and Factors Associated with Patient Outcomes Following Same-Day Discharge Percutaneous Coronary Intervention. Eur J Cardiovasc Nurs 2009; 8:190-9. [DOI: 10.1016/j.ejcnurse.2008.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 12/11/2008] [Accepted: 12/15/2008] [Indexed: 11/20/2022]
Abstract
Background: The demand for percutaneous coronary intervention (PCI) exerts constant pressure on health care systems to meet the growing needs of patients. The practice of same-day discharge PCI has emerged as a medically safe option to optimize resource utilization and improve access to care. Aim: The purpose of this study was to describe elective same-day discharge PCI patients' self-care behaviour in the two to five days following their procedure, and the factors associated with cardiac self-efficacy (CSE) and self-care agency (SCA). Methods: Using a cross-sectional correlational design, 98 consecutive patients were contacted by telephone, following PCI, and asked about their CSE, SCA, and adherence to discharge recommendations. Associations between selected variables were explored through multiple regression analysis. Results: The findings revealed a high degree of adherence to discharge recommendations, although participants' appreciation of the long term management of their chronic disease was limited. Factors associated with lower levels of CSE and SCA included the burden of having additional chronic co-morbidities, living alone and lacking social support, and a positive screening for psychosocial distress. Conclusion: Same-day discharge PCI presents a sustainable option for delivery of care for most patients. Some clients may require additional support to manage the transition between acute intervention and chronic disease management.
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Abstract
The Pennsylvania Patient Safety Authority's reporting system is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, and birthing centers, as well as some abortion facilities, must file information on medical errors. Safety Monitor is a column from the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafetyauthority.org. For the original article discussed in this column or for other articles on patient safety, click on "Patient Safety Advisories" and then "Advisory Library" in the left-hand navigation menu.
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Rolley JX, Davidson PM, Salamonson Y, Fernandez R, Dennison CR. Review of nursing care for patients undergoing percutaneous coronary intervention: a patient journey approach. J Clin Nurs 2009; 18:2394-405. [PMID: 19538559 DOI: 10.1111/j.1365-2702.2008.02768.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the existing literature to inform nursing management of people undergoing percutaneous coronary intervention. BACKGROUND. Percutaneous coronary intervention is an increasingly important revascularisation strategy in coronary heart disease management and can be an emergent, planned or rescue procedure. Nurses play a critical role in delivering care in both the independent and collaborative contexts of percutaneous coronary intervention management. DESIGN Systematic review. METHOD The method of an integrative literature review, using the conceptual framework of the patient journey, was used to describe existing evidence and to determine important areas for future research. The electronic data bases CINAHL, Medline, Cochrane and the Joanna Briggs data bases were searched using terms including: (angioplasty, transulminal, percutaneous coronary), nursing care, postprocedure complications (haemorrhage, ecchymosis, haematoma), rehabilitation, emergency medical services (transportation of patients, triage). RESULTS Despite the frequency of the procedure, there are limited data to inform nursing care for people undergoing percutaneous coronary intervention. Currently, there are no widely accessible nursing practice guidelines focusing on the nursing management in percutaneous coronary intervention. Findings of the review were summarised under the headings: Symptom recognition; Treatment decision; Peri-percutaneous coronary intervention care, describing the acute management and Postpercutaneous coronary intervention management identifying the discharge planning and secondary prevention phase. CONCLUSIONS Cardiovascular nurses need to engage in developing evidence to support guideline development. Developing consensus on nurse sensitive patient outcome indicators may enable benchmarking strategies and inform clinical trial design. RELEVANCE TO CLINICAL PRACTICE To improve the care given to individuals undergoing percutaneous coronary intervention, it is important to base practice on high-level evidence. Where this is lacking, clinicians need to arrive at a consensus as to appropriate standards of practice while also engaging in developing evidence. This must be considered, however, from the central perspective of the patient and their family.
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Affiliation(s)
- John X Rolley
- School of Nursing & Midwifery, College of Health Science, Curtin University of Technology, Level 7, 39 Regent Street, Chippendale, Sydney, NSW, Australia.
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Rezaei-Adaryani M, Ahmadi F, Mohamadi E, Asghari-Jafarabadi M. The effect of three positioning methods on patient outcomes after cardiac catheterization. J Adv Nurs 2009; 65:417-24. [DOI: 10.1111/j.1365-2648.2008.04889.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Bridget Shoulders-Odom
- Bridget Shoulders-Odom is a cardiology nurse practitioner at Tampa VA Hospital, Tampa, Florida
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Dumont CJP. Blood Pressure and Risks of Vascular Complications After Percutaneous Coronary Intervention. Dimens Crit Care Nurs 2007; 26:121-7. [PMID: 17440298 DOI: 10.1097/01.dcc.0000267807.95228.2e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Evidence-based protocols are needed for care of the nearly 1,000,000 patients in the United States who undergo percutaneous coronary interventional procedures. This article describes a case-matched control study of 300 patients undergoing percutaneous coronary intervention in which specific demographic, physician-sensitive, and nurse-sensitive factors were tested to determine their relative contribution to the incidence of vascular complications. Findings included that patients with a mean systolic blood pressure of 160 mm Hg or higher were 8 times more likely to have vascular complications (P < .001). Patients receiving heparin (with and without glycoprotein IIb/IIIa inhibitors) versus bivalirudin were 3 times more likely to have vascular complications (P = .008). Patients with hemostasis by AngioSeal and those with a history of hypertension were 77% (P =.031) and 61% (P = .005), respectively, less likely to have complications.
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