DOI QR코드

DOI QR Code

Development of Algorithm for Nursing Interventions after Percutaneous Coronary Intervention

경피적 관상동맥중재술 후 간호중재 알고리즘 개발

  • Received : 2016.11.03
  • Accepted : 2017.02.07
  • Published : 2017.02.28

Abstract

Purpose: The purpose of this study was to develop an algorithm for nursing care after percutaneous coronary intervention in order to improve patients' safety and prevent complications, because percutaneous coronary intervention is becoming a common treatment for coronary artery diseases. Methods: By reviewing related literatures and interviewing nurses, items and paths that were to be used in the algorithm for nursing care after percutaneous coronary intervention were drawn up and a draft algorithm was developed. The final algorithm was determined based on the results of the evaluation performed after clinical application. Results: According to the outcome after allowing nurses to apply the revised algorithm with 11 patients, suitability on items composing the algorithm were highly rated whereas promptness was lowly rated. Although the patients (n=11) to whom the algorithm was applied complained of less back pain (p=.001) and discomfort (p=.026) compared to the patients (n=17) to whom the algorithm was not applied, no significant difference in bleeding complication was found. Conclusion: The findings in the study support the clinical utilization of the algorithm for nursing care after percutaneous coronary intervention as the use of this algorithm reduced back pain and discomfort without increasing bleeding complications at the femoral puncture site.

Keywords

References

  1. Lee YW. Textbook of cardiovascular medicine. 1st ed. Seoul: Iljogak; 2001. p. 228.
  2. Statistics Korea. 2013 cause of death statistics [Internet]. Seoul: Statistics Korea; 2014 [cited 2014 September 23]. Avilable from: kostat.go.kr/smart/news/file_dn.jsp?aSeq=329181&ord=1.
  3. Odell A, Grip L, Hallberg LR. Restenosis after percutaneous coronary intervention (PCI): Experiences from the patients' perspective. European Journal of Cardiovascular Nursing. 2006;5(2):150-157. http://dx.doi.org/10.1016/j.ejcnurse.2005.10.004
  4. Health Insurance Review & Assessment Service. 2013 coronary artery bypass graft adequacy assessment [Internet]. Seoul: Health Insurance Review & Assessment Service; 2013 [cited 2014 December 12]. Available from: http://www.hira.or.kr/re/diag/getDiagEvlList.do?pgmid= HIRAA030004000000.
  5. Kee EJ. A study for discomfort and bleeding complications during absolute bed rest in patients undergoing percutaneous coronary intervention [master's thesis]. Suwon: Ajou University; 2001. p. 2.
  6. Brueck M, Bandorski D, Kramer W, Wieczorek M, Holtgen R, Tillmanns H. A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty. Journal of the American College of Cardiology: Cardiovascular Interventions. 2009;2(11):1047-1054. http://dx.doi.org/10.1016/j.jcin.2009.07.016
  7. Jones I, Goode I. Percutaneous coronary intervention. Nursing Times. 2003;99(27):46-47.
  8. Reynolds S, Waterhouse K, Miller KH. Head of bed elevation, early walking, and patient comfort after percutaneous transluminal coronary angioplasty. Dimensions of Critical Care Nursing. 2001;20(3):44-51. https://doi.org/10.1097/00003465-200105000-00013
  9. Rezaei-Adaryani M, Ahmadi F, Asghari-Jafarabadi M. The effect of changing position and early ambulation after cardiac catheterization on patients' outcomes: A single-blind randomized controlled trial. International Journal of Nursing Studies. 2009;46(8):1047-1053. http://dx.doi.org/10.1016/j.ijnurstu.2009.02.004
  10. Yun SY, Cho BH. The effects of heat therapy on low back pain, blood pressure and pulse rate after percutaneous coronary intervention. Journal of Korean Academy of Fundamentals of Nursing. 2011;18(3):348-355.
  11. Kim MH, Han MJ, Lee JE, Lee JM. Effects of exercise and ice pack therapy on discomfort after percutaneous coronary intervention. Journal of Korean Clinical Nursing Research. 2007;13(1):185-196.
  12. Nam SY, Choi-Kwon SM. The effects of fowler's position change on back pain and discomfort of the patients following percutaneous coronary intervention. Perspectives in Nursing Science. 2010;7(1):55-64.
  13. Enc N, Umman S, Agirbasli M, Altiok MG, Senuzun F, Uysal H, et al. Nursing care guidelines in percutaneous coronary and valvular intervention. Turkish Society of Cardiology. 2007: 1-30.
  14. Shoulders-Odom B. Management of patients after percutaneous coronary interventions. Critical Care Nurse. 2008;28 (5):26-42.
  15. Park SJ, Kim YH, Park DW, Kang HJ, Gwon HC, Kim GS, et al. Ischemic heart disease standard treatment recommendations. Seoul: Ischemic Heart Disease Clinical Research Center;2007. p. 1-38.
  16. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: A report of the American college of cardiology foundation/American heart association task force on practice guidelines and the society for cardiovascular angiography and interventions. Journal of the American College of Cardiology. 2011;58(24):e44-e122. http://dx.doi.org/10.1016/j.jacc.2011.08.007
  17. Rolley JX, Salamonson Y, Dennison CR, Davidson PM. Nursing care practices following a percutaneous coronary intervention: Results of a survey of Australian and New Zealand cardiovascular nurses. Journal of Cardiovascular Nursing. 2010;25(1):75-84. http://dx.doi.org/10.1097/JCN.0b013e3181bb419d
  18. Courtney M. Evidence for nursing practice. Marrickville: Churchill Livingstone; 2005.
  19. Dickerson SS, Sackett K, Jones JM, Brewer C. Guidelines for evaluating tools for clinical decision making. Nurse Educator. 2001;26(5):215-220. https://doi.org/10.1097/00006223-200109000-00010
  20. Rycroft-Malone J, Fontenla M, Seers K, Bick D. Protocol-based care: The standardisation of decision-making? Journal of Clinical Nursing. 2009;18(10):1490-1500. http://dx.doi.org/10.1111/j.1365-2602.2008.02605.x
  21. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007;30(4):459-467. http://dx.doi.org/10.1002/nur.20199
  22. Lee HJ, Kim DH. Development of a nasogastric tube feeding algorithm to prevent aspiration pneumonia. Journal of Korean Critical Care Nursing. 2014;7(1):1-10.
  23. Lee EJ. A study on the effect of massage and exercise on discomfort in patients following cardiac catheterization. Journal of Korean Nursing Administration Academic Society. 1997;3 (2):81-94.
  24. Park JS, Kim ES, Park CJ. The effects of the slow stroke back massage on discomfort in patients following percutaneous transluminal coronary angioplasty. Journal of Korean Clinical Nursing Research. 2004;9(2):56-67.
  25. Harper JP. Post-diagnostic cardiac catheterization: Development and evaluation of an evidence-based standard of care. Journal for Nurses in Staff Development. 2007;23(6):271-276. http://dx.doi.org/10.1097/01.NND.0000300833.54159.12
  26. Reynolds HR, Hochman JS. Cardiogenic shock: Current concepts and improving outcomes. Circulation. 2008;117(5):686-697. http://dx.doi.org/10.1161/CIRCULATIONAHA.106.613596
  27. Dumont CJ. Blood pressure and risks of vascular complications after percutaneous coronary intervention. Dimensions of Critical Care Nursing. 2007;26(3):121-127. http://dx.doi.org/10.1097/01.DCC.0000267807.95228.2e
  28. Mohammady M, Atoof F, Sari AA, Zolfaghari M. Bed rest duration after sheath removal following percutaneous coronary interventions: A systematic review and meta-analysis. Journal of Clinical Nursing. 2013;23(11-12):1476-1485. http://dx.doi.org/10.1111/jocn.12313
  29. Tongsai S, Thamlikitkul V. The safety of early versus late ambulation in the management of patients after percutaneous coronary interventions: A meta-analysis. International Journal of Nursing Studies. 2012;49(9):1084-1090. http://dx.doi.org/10.1016/j.ijnurstu.2012.03.012
  30. Yang JJ, Jang KS. Development of an algorithm for emergency nursing care of dyspneic patients. Journal of Korean Academy of Nursing Administration. 2009;15(4):491-505.