"Thumbs Up" for Quality and Patient Safety with Radial Artery Access
Post-op complications from femoral access for Cardiac Cath procedures prompted us to improve our clinical processes. The overall goal of the initiative practice was to increase our Radial Artery Access procedures to decrease our post-op complications,to improve patient outcomes and satisfaction.
Relevance/Significance:
Utilizing the Radial Artery for our access point during cardiac procedures will decrease post-op complications, mortality rates and patient's length of stay. Observed symptomatic complications occur only 3-6% of the time due to the intricate palmar circulation. A coronary procedure with a femoral access approach has a 10% risk of severe post-op complications leading to mortality. Radial Artery access demonstrates reduced patient hospital cost and length of stay by 15% (Rao, et al., 2008).
Strategy and Implementation:
In 2011 our Cardiac Catheterization Lab (CCL) was not performing any Radial Artery access. We then implemented the new routine of Radial Artery access starting first with planned Diagnostic Coronary outpatients' population. Based on the evidence supporting this innovative technique, we collaborated with our Cardiology group to implement this best practice change. Nursing staff was supported with resources and education including a competency on the “Thumbs Up” procedure for Radial Artery assessment utilizing the Modified Allen's Test. Nursing education encompassed an understanding of medications, equipment set up, procedural steps and patient education pieces. As our Radial Artery practice expanded in our patient population, education was then connected to include outlying departments that would be involved in post-op monitoring. In 2013 our CCL department extended this process improvement to include our Acute Coronary Catheterization clients.
Evaluation:
Currently 75% of all coronary procedures utilize Radial Artery access. Outcomes of Radial Artery access show patients ambulate earlier, experience less pain and have fewer restrictions during recovery. Length of stay is reduced cutting costs. Education was extended to all areas caring for patient's pre and post Radial Artery procedures. Nurses demonstrate expertise with new process.
Implications for Practice:
As technology advances nursing staff is challenged to implement innovative practice changes to enhance quality and improve patients' outcomes. Increasing Radial Artery access ensures we are providing the best care practices for our patients.