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Background Patients with indwelling pulmonary artery catheters have historically been excluded from participating in early mobility programs because of the concern for catheter-related complications. However, this practice conflicts with the benefits accrued from early mobilization. Objective The purposes of this quality improvement project were to develop and implement a standardized ambulation protocol for patients with a pulmonary artery catheter in a cardiac surgery intensive care unit and to assess and support safe ambulation practices while preventing adverse events in patients with pulmonary artery catheters. Methods From October 2016 through October 2017, this single-center quality improvement project developed and analyzed the implementation of a safe patient ambulation protocol in the cardiac surgery intensive care unit. Frontline nursing staff and the interdisciplinary team were educated on a standardized protocol that facilitated patient ambulation. Data analyzed included distance of ambulation, catheter migration, presence of cardiac dysrhythmias, and adverse events during ambulation. Results During this 1-year project, 41 patients participated in 94 walks for a total distance of 13 676.38 m. There were no reported episodes of cardiac dysrhythmia, accidental occlusion of the pulmonary artery, catheter migration, or pulmonary artery rupture related to ambulation with a pulmonary artery catheter. Conclusions The use of a standardized ambulation protocol can successfully result in safe mobilization of patients with indwelling pulmonary artery catheters.
Background Patients with indwelling pulmonary artery catheters have historically been excluded from participating in early mobility programs because of the concern for catheter-related complications. However, this practice conflicts with the benefits accrued from early mobilization. Objective The purposes of this quality improvement project were to develop and implement a standardized ambulation protocol for patients with a pulmonary artery catheter in a cardiac surgery intensive care unit and to assess and support safe ambulation practices while preventing adverse events in patients with pulmonary artery catheters. Methods From October 2016 through October 2017, this single-center quality improvement project developed and analyzed the implementation of a safe patient ambulation protocol in the cardiac surgery intensive care unit. Frontline nursing staff and the interdisciplinary team were educated on a standardized protocol that facilitated patient ambulation. Data analyzed included distance of ambulation, catheter migration, presence of cardiac dysrhythmias, and adverse events during ambulation. Results During this 1-year project, 41 patients participated in 94 walks for a total distance of 13 676.38 m. There were no reported episodes of cardiac dysrhythmia, accidental occlusion of the pulmonary artery, catheter migration, or pulmonary artery rupture related to ambulation with a pulmonary artery catheter. Conclusions The use of a standardized ambulation protocol can successfully result in safe mobilization of patients with indwelling pulmonary artery catheters.
Background: A systematic training program has not been developed for pulmonary artery catheter (PAC) patient care in Taiwan; only the mentor-apprentice learning approach is used. Therefore, it is difficult for nursing personnel to maintain mastery of care. Methods: ICU nurse practitioners of regional teaching hospitals were enrolled in this study to perform pretest, post-test, and repeated measurements in order to examine the long-term learning effectiveness of this intervention. Before and after e-learning using the PAC Teaching DVD and high-tech simulation interventions, this study used scales to assess knowledge, attitude, technique inspection, and satisfaction with the PAC Teaching DVD to collect data. Results: The differences in the posttest scores and repeated measurements in the areas of knowledge and techniques of PAC patient care reached significance (p < .05). The differences in scores in the care attitude areas of "Beneficial to the improvement of self-confidence in care" and "I believe that I can provide accurate data for decision-making" post-test and those in the area of "During insertion of a pulmonary artery catheter in patients, I will look up information to look for answers" reached significance (p < .05). The learners were all satisfied with the PAC Teaching DVD. Conclusion: This study considered the needs of learners, and developed the PAC Teaching DVD according to theory. The results showed that the interventions had a long-term learning effectiveness in terms of knowledge, attitude, and techniques of PAC patient care. This research can be used as a reference for training in the care of PAC patients.
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