Objective:To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Method: Cross-sectional study with retrospective data collection. Results: Overall, 345 patients were included; 116 (34%) experienced postprocedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. Conclusion: The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. DESCRIPTORSPain; Acute Pain; Pain Management; Endovascular Procedures; Nursing Care. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratoryAvaliação e manejo da dor em pacientes submetidos a procedimentos endovasculares em laboratório de hemodinâmica Evaluación y tratamiento del dolor en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterismo INTRODUCTIONEndovascular procedures involve the insertion of radiopaque catheters, via percutaneous venous or arterial puncture (femoral, brachial, or radial) under fluoroscopy guidance, to arrive at the desired location (heart, peripheral vessels, cerebral vessels). These procedures are carried out in catheterization laboratories ("cath labs") for purposes both diagnostic (evaluation of blood flow) and therapeutic (treatment of obstructions, stenoses, or correction of aneurysmal lesions) (1) . A common complaint of patients undergoing endovascular procedures is acute pain at the vascular access site or discomfort in the chest and lower back area, which may be related to bedrest, restricted movement of the accessed limb, to the trauma of vascular puncture itself, or to the potential vascular complications that may develop during the procedure (2)(3)(4) . However, other pain complaints, such as back pain or headache, are also very common in this setting (2)(3)(4)(5)(6) . Considering that the high turnover and dynamics of cath lab work may hinder proper care of pain, staff must pay special attention to assessment, management, and systematic recording of pain levels.Despite substantial growth of endovascular procedures in recent decades (3)(4)(5) , assessment of pain in the post-procedural period does not appear to be a major concern of care teams. Few studies have addressed this topic as a primary outcome in this setting (6)(7)(8) ; in others, pain was assessed a secondary or less important outcome (2) . It is known that inadequate management of postoperative pain can prolong hospitalization, increase healthcare expenditures, and have several clinical repercussions, including changes in blood pr...
Objective: To describe the process of implanting the surgical safety checklist in a catheterization laboratory (CL). Method: Descriptive case report study about the safety strategies developed in the last six years in a university hospital in the southern region of Brazil. Results:The six international patient safety goals (IPSG) were incorporated into the care practice in accordance with the hospital's Joint Comission International (JCI) accreditation program, through a continuous process of educational nature. The checklist was adapted considering the characteristics of the unit and the procedures performed. Conclusion:The implementation of the checklist provided the promotion of patient safety, greater staff integration, advances in communication among professionals and the recording of in-room care information.Objetivo: Descrever o processo de implantação da lista de verificação de segurança cirúrgica em laboratório de cateterismo (LC). Método: Estudo descritivo do tipo relato de experiência das estratégias de segurança desenvolvidas nos últimos seis anos em hospital universitário da região Sul do Brasil. Resultados:Foram incorporadas na prática assistencial as seis metas internacionais de segurança do paciente (MISP) em consonância com o programa de acreditação hospitalar pela Joint Comission International (JCI), por meio de um processo contínuo com caráter educativo. A lista de verificação foi adaptada considerando as características da unidade e os procedimentos realizados. Conclusões:A implantação da lista de verificação proporcionou a promoção da segurança do paciente, maior integração da equipe, avanços na comunicação entre os profissionais e no registro das informações da assistência em sala. Palavras-chave:Segurança do paciente. Lista de checagem. Acreditação hospitalar. RESUMEN Objetivo: Describir el proceso de implantación de la lista de verificación de seguridad quirúrgica en un laboratorio de cateterismo (LC). Método: Estudio descriptivo del tipo relato de experiencia sobre las estrategias de seguridad desarrolladas en los últimos seis años en un hospital universitario de la región Sur de Brasil.Resultados: Se incorporaron en la práctica asistencial las seis metas internacionales de seguridad del paciente (MISP) en consonancia con el programa de acreditación hospitalaria por la Joint Comission International (JCI), a través de un proceso continuo con carácter educativo. La lista de verificación fue adaptada considerando las características de la unidad y los procedimientos realizados.Conclusión: La implantación de la lista de verificación proporcionó la promoción de la seguridad del paciente, una mayor integración del equipo, avances en la comunicación entre los profesionales y en el registro de las informaciones de la asistencia en sala.Palabras clave: Seguridad del paciente. Lista de verificación. Acreditación de hospitales. How to cite this article: Reich R, Santos SM, Goes MGO, Romero PS, Casco MF, Kruger J, et al. Surgical safety in catheterization laboratory. Rev Gaúcha Enferm. 2019;40(esp):e...
Background: Reuse of dental and medical devices is a worldwide common practice, and our country is not an exception; its aim is to reduce procedural costs. PTCA insufflation devices (or manometers) are frequently resterilized for clinical reuse purposes. Evaluations of their physical and mechanical properties are not described in current literature. Objective: Determine if the physical and functional characteristics of insufflation devices are maintained after reuse processing, as well as establish their life span. Methods: This was a prospective longitudinal study, carried out at university hospital in Porto Alegre, RS, Brazil. From November 2007 to March 2008, all new insufflation devices were included and separated in two different groups: Group A devices were evaluated immediately after their first use and Group B devices were evaluated after subsequent uses. Results: Of the 36 devices, 11 (30.6%) were discarded after the first use due to severe mechanical or functional problems. Of the remaining devices, only 8 (32%) in Group A and 6 (24%) in Group B kept totally preserved functionality. These devices presented significant changes, even though they were mild, in measurements after 12 atm. Mean reuse rate was 1.7 ± 1.2 times. Conclusions: Results showed that about 30% of PTCA insufflation devices were not in working conditions after the first use. Only a quarter of the remaining
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