الفهرس | Only 14 pages are availabe for public view |
Abstract SUMMARY Cardiac catheterization (CC) is a cornerstone procedure for the diagnosis and treatment of coronary artery disease. It offers numerous benefits, including rapid recovery, fewer post-operative complications, and improved quality of life. However, like any other invasive procedure, it carries potential risks. Local complications include hematoma, infection, and arterial trauma. Systemic complications such as arrhythmia, allergic reactions, and air embolism are also possible. These complications can negatively impact clinical outcomes and patient satisfaction. Nursing care plays a critical role in mitigating these risks. By providing thorough pre- procedure education about the procedure and potential complications, nurses empower patients to actively participate in their care. Additionally, vigilant monitoring and prompt intervention are keys to detect and manage complications as early as possible and minimizing their impact. Ultimately, effective nursing care can significantly improve both clinical outcomes and patient satisfaction for those patients undergoing CC. Therefore, the present study aimed to assess clinical outcomes and satisfaction level among patients undergoing diagnostic cardiac catheterization. Research questions 1. What are the clinical outcomes among patients undergoing diagnostic cardiac catheterization? 2. What is the satisfaction level among patients undergoing diagnostic cardiac catheterization? Research design A descriptive cross-sectional research design was utilized to collect data in this study. Setting This study was conducted at the CC unit in the cardiology department of Damanhour Medical National Institute, El-Beheira governorate, Egypt. Subjects: A convenience sample of 110 adult male and female patients undergoing diagnostic cardiac catheterization was included in the study. Tools of the study To fulfill the aim of the study, three tools were used for data collection. Tool I: ” Patients’ vascular access site assessment sheet”: It included three parts that assessed patients’ personal and clinical data, vital signs as well as vascular access site. Tool II: ”Patients’ clinical outcomes post diagnostic cardiac catheterization assessment sheet” It included two parts that assessed the patient’s pain (access site pain and back pain) and post-diagnostic cardiac catheterization complications including minor local, major local, and systemic complications. Summary 61 Tool III: ”Patient satisfaction structured interview questionnaire”: This tool included items that revised patient satisfaction with nursing care regarding CC. Methods The researcher developed two study tools and adopted one tool based on a review of recent literature. To ensure content validity, completeness, and clarity, the tools were revised by a jury of 5 experts in medical-surgical nursing and cardiology. The experts assessed item relevance, clarity, and comprehensiveness, and their feedback was used to modify the tools. A pilot study involving 11 patients, representing 10% of the sample excluded from the studied sample, they were conducted to test the applicability, clarity, and feasibility of the tools. The tools demonstrated good reliability, with Cronbach’s alpha values exceeding 0.79. Data collection: After securing administrative approval, data collection was completed in two months (May- June 2023). A convenient sample of 110 adult patients undergoing diagnostic cardiac catheterization, who met the inclusion criteria, were recruited from the CC unit of Damanhour Medical National Institute. A structured interview schedule was conducted with each patient twice, before and after the CC procedure, during morning and evening shifts on Sundays, Tuesdays, Wednesdays, and Thursdays weekly. The first interview occurred before the procedure in the morning at the CC department. The second interview was conducted 6 hours post-procedure for patients accessed via the femoral artery and 3 hours post-procedure for patients accessed via the radial artery (just before discharge, according to hospital policy). Statistical analysis of the data After completion of data collection, statistical tests were carried out using SPSS, version 25 for both data presentation and statistical analysis of the result. The number and percentage were used for describing and summarizing qualitative data. Mean and standard deviation were used to present the quantitative data. The main results of the study • Approximately two-thirds of the studied patients fell into the age group of 50 to 60 years, and more than half of the patients were males. • More than two-thirds of the studied patients had a duration of pressure hold to achieve hemostasis ranging from 10 to less than 20 minutes. • More than two-thirds of the studied patients had normal and acceptable vascular access site assessment pre-CC, while more than half had impaired and severely impaired vascular access site assessment post-CC. • Majority of the patients in the study reported having pain in both the back and insertion site and experienced relatively mild post-CC complications. • Most of the patients expressed a satisfactory level of satisfaction with their overall experience in the CC unit. • There were statistically significant positive relationships between total complications and gender, level of education, place of residence, and the duration of pressure held to achieve hemostasis. Summary 62 Conclusion Based on the results of the present study and research questions, the study concluded that more than two-thirds of the studied patients had normal and acceptable vascular access sites pre-CC, while more than half of them had impaired and severely impaired vascular access sites post-CC. The majority of the patients in the study reported having mild to moderate pain in both insertion sites and the back, experienced relatively mild post-CC complications, and expressed satisfaction with the level of nursing care experienced in the CC unit. Additionally, there were statistically significant positive relationships between total complications and gender, level of education, place of residence, and the duration of pressure held to achieve hemostasis. Recommendations Based on the findings of this study, the following recommendations are suggested: 1) Recommendations for patients: • Health teaching for patients on how to observe and care for access sites before and after DCC. • Provide a colored illustrated booklet for each patient with DCC about the procedure and relevant outcomes. • Ensure patients are adequately informed about CC, risk factors, complications, and what to do if occur before discharge from the hospital. 2) Recommendations for nurses: • Regular updated in-service training programs regarding nursing care of complications and risk factors for patients undergoing DCC. • Develop instruction checklist for vascular access site assessment pre and post-DCC as part of routine nursing care for patients undergoing DCC. • Encourage and support nurses in attending national and international conferences, workshops, and training courses related to nursing care for patients undergoing CC. 3) Recommendations for further research: • Investigate the effect of implementing a protocol of nursing care on patients’ clinical outcomes for those undergoing DCC. 4) Recommendations for education: • Include the assessment of vascular access site and post-CC complications and care in academic nurses’ curricula and training workshops in all Egyptian nursing schools. 5) Recommendations for organizations: • Conduct regular staff meetings to discuss weak and strong points regarding the application of CC nursing care and the prevention of complications. • Conduct continuous supervision and evaluation systems regarding the application of nursing care for patients undergoing CC procedures. |