Enhancing Outcomes for Outpatient Percutaneous Coronary Interventions

Abstract

Purpose and Objectives:A quality improvement project was conducted to create a sustainable continuum of care for increased volumes of outpatients receiving percutaneous coronary interventions. Dramatic growth exposed system vulnerabilities and left staff overwhelmed. Four postinterventional project objectives included reducing preprocedural preparation times, reducing bleeding complications, reducing hospital length of stay, and collectively increasing patient satisfaction.Description of the Project:Amidst creating a specialized postintervention coronary recovery area and acquiring and training existing preregistration and recovery nurses, a fragmented system of care was united. The clinical nurse specialist–led project used a systematic and evidence-based implementation process to harmoniously acclimate perioperative staff. An evaluation process further defined new opportunities to support a growing service line.Outcomes:Postimplementation data were collected over a 3-month period. An overall improvement was found in all targeted objectives, despite an upsurge in case volumes. A moderately significant correlation (r [105] = 0.424, P < .001) was found between bleeding occurrences and hospital length of stay.Conclusion:The synergy between interdepartmental collaboration and strategic staffing reallocation was shown to be invaluable to alleviate procedural areas of service, such as the cardiac catheterization laboratory. As a project champion, the clinical nurse specialist is an essential catalyst to identify and creatively surmount system-level challenges.

Efforts to reduce the length of stay in a low-intensity ICU: Changes in the ICU brought about by collaboration between Certified Nurse Specialists as head nurses and intensivists

“…Specifically, the Advanced Practice Nurse (APN) plays a significant role in intensive care, improving bedside care, consultation, and ethical coordination. [2][3][4][5][6][7] An APN has a master's or doctoral degree and contributes to the development of bedside care through evidence-based direct care, multi-professional collaboration, and education. Certified Nurse Specialist (CNS) is one of the titles recognized as an APN in Japan.…”