IS A HIGH DEPENDENCY UNIT 1 CORONARY CARE UNIT REQUIRED FOR POST CARDIAC INTERVENTION PROCEDURES?
S.R. Cleary, M. Dahl. A. Paine *
The Prince Charles Hospital, Brisbane
Traditionally nursing care of Percutaneous Transiuminal Coronary Angioplasty (PTCA) patients post procedure has been undertaken in a Coronary Care Unit. Moves towards post procedure nursing care for elective PTCA patients in a ward without cardiac monitoring was initiated at the Prince Charles Hospital in 1993. Prior to 1993 all PTCA patients were nursed in the coronary care unit. The decision to initiate these changes was affected by a number of factors, including the need to increase the number of PTCA cases, improved safety of the procedure and a reduction of post procedure complication rates. From October 1997 - October 1998 catheter lab nurses collected retrospective data from 670 PTCA patients. The charts were audited to elicit the necessity of transfer post procedure to a high dependency or coronary care unit.
Total patients: 670 patients.
Unmonitored Ward 1 A -595, Monitored CCU -70, Monitored ICU 1 Post op -5.
The results indicated that transfer to a high dependency 1 coronary care area was facilitated for the following reasons: No bed available on ward I A - 46 patients, medical preference for cardiac monitoring -24, intubation requirement - 1 patient and post emergency CABG - 4 patients
Conclusions drawn from these results demonstrate that patient outcome and safety is not compromised when post procedure care is undertaken in a ward setting, without cardiac monitoring, by nurses educated in cardiac nursing.
