SP51 Factors that Influence the use of Physical Assessment Skills by Cardiac Nurse: Results from a Longitudinal Qualitative Descriptive Research Study

Abstract

admission clinic improved patient's outcomes after angioplasty. Secondary outcome measures were the time required to prepare patients for angioplasty on the day of admission and the staff's experience of patients having attended the pre-admission clinic. Methods: A randomised controlled clinical pilot study of patients undergoing booked PTCA at a tertiery centre. Patients were recruited between March and November 2006. The study consisted of 2 groups, "usual care" or control group and "clinic" group or intervention group. The "usual care" group received the care given to patients undergoing booked PTCA at the time of the study-they received an information pack prior to admission and were clerked on admission. If the patients were not already taking Aspirin and Clopidogrel they were given a loading dose of Clopidogrel 600mg on admission. The "clinic" group attended the pre-admission clinic approximately 1 week prior to their planned date of admission. The clinic consisted of an information seminar in the morning and a clinic appointment in the afternoon conducted by a Nurse Consultant/Nurse Specialist. Patients were also seen by the pharmacist, who discussed their medication with them. Blood tests and an ECG were taken. Patients not already taking dual anti-platelet therapy were prescribed Clopidogrel 75mg od to be commenced 1 week prior to admission. The study was evaluated by the use of the CROQ questionnaire. The clinic group patients were also asked to evaluate the information seminar and a ward staff questionnaire was given to 8 staff involved in caring for patients admitted for booked PTCA. Results: A total of 37 patients were recruited. Five patients withdrew from the study, 3 in the control group and 2 in the clinic group. The mean scores for symptoms, physical functioning, cognitive functioning and psychosocial functioning all improved post PTCA. The mean scale for adverse effects post PTCA was very high indicating that there were very few adverse effects in this group. There were no significant differences between the groups pre and post procedure. The numbers were too small to reach significance however several problems were highlighted with blood results which needed attention prior to admission. Conclusion: The PTCA pre-admission clinic was well accepted by the staff and patients involved. This type of clinic can be nurse-led and may identify problems which need to be addressed prior to the procedure. The clinic facilitates smooth pre-procedural care and inproves the quality of care patients receive.