在护士协调的标准化协议下,在心房移除心房后,同日出院
Teresa Espinosa1, Anna Farrus1, Montserrat Venturas1
1Department of Cardiology, Cardiovascular Institute (ICCV), CLÍNIC-Barcelona University Hospital, Carrer Villarroel 170, 08036 Barcelona, Catalonia, Spain.
概括
在心房 (AF) 除后,当同日排泄 (SDD) 是安全和有效的,当由护士使用标准化协议进行协调时. 这种方法简化了护理并减少了并发症,特别是在超声波引导的股骨穿刺中.
科学领域:
- 心脏病学 心脏病学
- 医疗保健管理的管理
背景情况:
- 在心房动 (AF) 废除后,当日出血 (SDD) 可以节省医疗保健资源.
- 确保安全和有效的物流是SDD计划的关键挑战.
- 建议采用简化,护士协调的方法来应对这些挑战.
研究的目的:
- 实施和评估一个护士协调的,标准化的协议,在AF切除后在同一天出院.
- 评估SDD程序的安全性,效率和资源利用情况.
主要方法:
- 一位专门的护士协调员管理了整个SDD协议,从患者的资格到出院后的随访.
- 资格标准包括左心室喷射率 (LVEF) ≥35%,家庭支持和接近医院.
- 在初始阶段之后,超声指导的股骨穿刺是强制性的.
主要成果:
- 在420名查患者中,331人符合条件,300人 (91%) 在同一天成功出院.
- 没有发生严重的SDD后并发症;计划外医疗护理和再入院率很低 (分别为6.3%和1.6%).
- 超声波引导的穿刺显著减少了大腿部接入部位并发症 (P = 0.0145).
结论:
- 按照标准化协议进行护士协调的SDD是AF切除的安全有效模式.
- 门诊心脏干预护士可以作为SDD过渡的有效协调员.
- 在SDD程序中,超声引导的股骨穿刺对于最大限度地减少访问部位并发症至关重要.
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