Assessment Framework for Recognizing Clinical Deterioration in Patients With ACS Undergoing PCI

Area of Science:

• Cardiology
• Nursing
• Critical Care

Background:

• Patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) face risks of clinical deterioration.
• Deterioration signs can be non-specific, complicating early diagnosis and intervention.
• Previous nursing assessments showed inconsistencies in recognizing and prioritizing critical cues.

Purpose of the Study:

• To present a framework for nurses to enhance physiological cue collection during PCI.
• To improve the recognition of clinical deterioration in ACS patients undergoing PCI.
• To facilitate timely and targeted interventions for specific forms of deterioration.

Main Methods:

• Literature analysis to identify forms of clinical deterioration during PCI.
• Review of pathophysiology, incidence, severity, and clinical features of each deterioration type.
• Development of a focused clinical assessment framework for nurses.

Main Results:

• Identified 7 forms of clinical deterioration during PCI: coronary artery occlusion, stroke, ventricular rupture, valvular insufficiency, lethal cardiac arrhythmias, bleeding, and anaphylaxis.
• Highlighted key differences in assessment findings for specific deterioration types.
• Proposed a framework for focused nursing assessments to improve recognition.

Conclusions:

• Clinical deterioration during PCI significantly increases mortality and morbidity.
• A structured, focused assessment framework can optimize nursing recognition of specific deterioration forms.
• Improved cue collection and prioritization are crucial for effective periprocedural care in ACS patients.