Abstract W P348: Decreasing Variability in Post Cerebral Angiogram Care
Background: A random chart (N 25) audit of angiogram post care protocol was completed to assess for nursing compliance in performance of defined frequency of vitals, neurological and groin assessment. The audit showed only 5 out of 25 (20%) had completed all post nursing care interventions. There were no groin complications in that small population but the inconsistency of care increased the risk of safe patient care in a large comprehensive stroke center where seven hundred diagnostic angiograms are performed annually.
Purpose: The goal of this quality-initiated project was to explore post angiogram care and decrease variation in the assessment process and to eliminate or decrease potential complications.
Methods: Data showed decreased compliance among nursing staff in the neuroscience units. Process variability included: two post angiogram order sets (neuro interventional and cardiovascular) with differing care protocol; multiple units care for patients; and unit staffing grid was not intended to manage patients with frequent assessment. Initially education was provided through 1:1 communication of protocol with all clinical staff and posters were hung in clinical areas. Next, administrative leaders recognized the burden on nursing and the risk of patient safety and supported care of the post procedure angiogram in the PACU for two hours. Lastly, the two physician groups reviewed the order sets together and agreed upon defined frequency of vitals and assessments.
Results: There was an improvement of 350% over baseline at the last interval measure. To date, there have been no adverse events or complications reported in this patient population. The project succeeded in achieving its stated goals; monitoring is ongoing.
Conclusions: Data to drive performance improvement. When patients are cared for in separate locations by a different team, there may be variations in the care processes. Communication and education are vital to ensure that excellent and safe care is being provided to the patients. All levels of management as well as the clinicians must be provided with the information needed to support the safest and highest quality of care to our patients.
Author Disclosures: A. Hawkins: None. D. Summers: None. J. Kelsey: None. D. Hunt: None.
- © 2015 by American Heart Association, Inc.