Greater Nursing Role for Enhanced Post-Percutaneous Coronary Intervention Management

Effects of multiple protection model in the operating room on physiological stress and risk events in patients undergoing coronary artery stent implantation

OBJECTIVE

To analyze the impact of multiple protection model in the operating room on patients' physiological stress and risk events after coronary artery stent implantation (CASI).

METHODS

During October 2021 to October 2022, 150 patients with coronary heart disease (CHD) were picked as the research subjects, all of whom underwent CASI. The clinical data were retrospectively analyzed, and the patients were divided into two groups according to different nursing methods, with 75 cases in each group. Patients in the intervention group received multiple protection model intervention in the operating room, and the patients in the control group adopted conventional care model. The patient satisfaction with nursing, postoperative recovery, psychological stress scores, physiological stress indicators, and adverse cardiac risk events were recorded.

RESULTS

Patients in the intervention group had much higher percentage of the patient satisfaction with nursing than those in the control group (P < 0.05). The time to get out of bed and hospital stay was significantly shorter and the 6-min walking distance was markedly longer in the intervention group than the control (P < 0.05). The Hamilton Anxiety (HAMA) scale and Hamilton Depression (HAMD) scale score of patients in two groups were sharply decreased after the intervention (P < 0.05), which were strongly lower in the intervention group than the control (P < 0.001). After the intervention, the heart rate, cortisol and epinephrine of patients were all sensibly elevated in two groups (P < 0.05), which were all memorably lower in the intervention group than the control (P < 0.001). The incidence of adverse cardiac risk events in the intervention group was 5.33%, which was dramatically lower than 16.00% in the control group (P < 0.05).

CONCLUSION

The application of multiple protection model in the operating room on patients undergoing coronary stent implantation promoted postoperative recovery, reduced patients' psychological and physiological stress, maintained blood pressure and other vital signs, reduced the incidence of adverse cardiac risk events, and improved the patient satisfaction with nursing.

Perceived social support among percutaneous coronary intervention patients over a long-term follow-up period

AIM

To investigate perceived social support and the associated factors as well as the sources of social support among post-percutaneous intervention patients over a long-term follow-up period.

DESIGN

An explanatory and descriptive survey with a six-year follow-up (STROBE Statement: Supplementary file 1).

METHODS

Baseline data (n = 416) were collected from Finnish patients in 2013, with follow-up data collected from the same study group in 2019 (n = 154). The research employed the Social Support of Patients with Coronary Heart Disease self-reported questionnaire. Data were analysed using descriptive statistics and multivariate methods.

RESULTS

In the acute phase, higher informational support was associated with lower LDL cholesterol and female gender and higher emotional support with working status. In long-term follow-up period, physical activity, younger age, normal cholesterol levels and previous percutaneous coronary intervention predicted higher informational support, regular participation in follow-up sessions and relationship status predicted higher emotional support, and previous coronary artery bypass grafting, smoking, alcohol consumption, normal cholesterol and regular follow-ups predicted higher functional support.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Application of checklist-based nursing care process in patients undergoing intervention for coronary chronic total occlusions: a quasi-randomized study

BACKGROUND

Coronary chronic total occlusion (CTO) interventions are more complex than general percutaneous coronary intervention (PCI) procedures. However, only a few nursing methods are specifically applied to patients undergoing CTO interventions. And the conventional nursing effect is not ideal, urgent need to explore more effective nursing methods. The checklist is a simple and effective tool for error management and performance improvement that has been widely used in many fields. But there have been no reports of the checklist being used to improve care for CTO patients.

OBJECTIVE

This study aimed to investigate the effectiveness of a checklist-based nursing care process in patients undergoing Coronary chronic total occlusion (CTO) interventions, including duration of care, patient anxiety, improved patient satisfaction, and occurrence of adverse events.

METHODS

A total of 120 CTO patients undergoing percutaneous coronary intervention (PCI) were selected at our hospital and divided into an intervention group (n = 60, adopted the checklist-based nursing care process for patient care) and a control group (n = 60, adopted nursing care according to the existing workflow) according to different nursing interventions. After surgery, the nurse in charge of the patient completed the nursing according to the "List of postoperative care for CTO patients" filled in by the patient within 24 h after surgery, conducted a doctor satisfaction survey, recorded adverse events, and completed the postoperative Self-Rating Anxiety Scale (SAS) score and patient satisfaction survey before the patient was discharged. Subsequently, the Qc team checks the completion of the patient's checklist for safety and the completion of the questionnaire. Finally, the differences between the two groups in preoperative nursing time, incidence of adverse events caused by nurses' omission or inadequate guidance, patient anxiety, and doctor and patient satisfaction were compared.

RESULTS

The intervention grouphad significantly shorter preoperative nursing care time and significantly lower the total number of adverse events than the control group (P < 0.05).The postoperative Self-Rating Anxiety Scale (SAS) score of the intervention group was significantly lower than that of the control group (P < 0.05).The satisfaction of doctors and patients in the intervention groupwas significantly higher than that in the control group (P < 0.05).

CONCLUSION

The application of the checklist-based nursing care process in patients with CTO intervention can significantly reduce the preoperative nursing care time, reduce patient anxiety, improve patients' and doctors' satisfaction with nursing care, and effectively reduce the occurrence of adverse events caused by nurses' omissions or inadequate instructions.

TRIAL REGISTRATION

The protocol of the trial was registered retrospectively of Chinese Clinical Trial Registry (registration number ChiCTR2200056804, reg date17/02/2022).

Effects of empowerment education on patients after percutaneous coronary intervention: A meta-analysis and systematic review

BACKGROUND

Empowerment education is a new nursing education model with great significance in the process of chronic disease rehabilitation, and a number of studies have found that it has good benefits for patients after percutaneous coronary intervention (PCI). But there is no meta-analysis on how empowerment education influence the life of patients after PCI.

AIMS

Our study intends to evaluate the impact of empowerment education on the quality of life, cognitive level, anxiety and depression level of patients after PCI.

DESIGN

Systematic review and meta-analysis, following PRISMA guidelines.

METHODS

RevMan5.4 software and R software were used for statistical analysis. Mean difference or standard mean difference was used as effect analysis statistic for continuous variables with 95% confidence intervals.

RESULTS

Six studies met the inclusion criteria, including 641 patients. The Exercise of Self-Care Agency Scale score of the experimental group was higher than that of the control group, with statistically significant difference. Empowerment education could increase the knowledge of coronary heart disease in patients after PCI, but the difference was not statistically significant.

CONCLUSION

Significant effects of empowerment have been found in improving patients' quality of life and self-care ability. Empowerment education could be a safe exercise option in PCI rehabilitation. However, the effect of empowerment on cognitive level for coronary heart disease and the depression needs to carry out more large-sample, multi-center clinical trials.

PATIENT OR PUBLIC CONTRIBUTION

A data-analysis researcher and 3 clinicians are responsible for the writing, and no patients participated in the writing of this paper.

Nurses' healing presence: A panacea for the comfort of acute coronary syndrome patients in CCU, A qualitative study

AIM

The study aimed to explain the acute coronary syndrome (ACS) patients' perception of the nurse's healing presence in their comfort in the critical care unit.

DESIGN

This descriptive qualitative study was conducted from December 2020 to September 2021.

METHODS

Twenty-seven ACS patients were purposively selected from a cardiovascular university Hospital, Iran. Data were collected through semi-structured interviews (45-60 min). Data analysis was performed based on the contractual content analysis method of Graneheim and Lundman.

RESULTS

In the data analysis, the main theme 'nurses' healing presence' includes two categories: 'Nurse-patient communication' with two subcategories and the category 'Compassionate care' with three subcategories.