ABSTRACT
Based on updated evidence, a radiology nurse systematically engaged a multidisciplinary staff in testing a protocol to prevent contrast-induced nephropathy related to computed tomography. In a quality improvement project, the protocol combined preprocedure oral hydration with postprocedure intravenous saline. This protocol safely improved kidney function, reduced postprocedure time, and decreased annual cost. By applying theory, being persistent, presenting sound evidence, and unifying the team, one concerned staff nurse profoundly affected patient care and policy in an entire medical center.
Subject(s)
Clinical Protocols/standards , Contrast Media/administration & dosage , Fluid Therapy/nursing , Kidney Diseases/nursing , Nurse's Role , Sodium Chloride/administration & dosage , Tomography, X-Ray Computed/nursing , Adolescent , Adult , Aged , Contrast Media/adverse effects , Evidence-Based Medicine , Female , Humans , Infusions, Intravenous , Interdisciplinary Communication , Kidney Diseases/chemically induced , Kidney Diseases/diagnostic imaging , Kidney Diseases/prevention & control , Male , Middle Aged , Radiology/standards , Radiology/trends , Risk FactorsABSTRACT
Patients scheduled for vascular angiography are often anxious and frightened. High levels of anxiety may result in more difficult and painful procedures. Past research has reported mixed results for anxiety reduction techniques in other procedures settings, such as education, cognitive-behavioral skills, coping and relaxation skills, combinations of techniques, and music. Music as an intervention for pre-procedural anxiety prior to vascular angiography has not been studied. A randomized controlled trial of 170 patients was undertaken to determine whether 15 minutes of self-selected music reduced pre-procedure anxiety. The State Trait Anxiety Inventory was used to measure patients' anxiety. One-hundred sixty-six men and 4 women comprised the sample with an average age of 66.8 years (SD 9.95, range 37 to 85 years). Patients who listened to music (n=89) reduced their anxiety score from 38.57 (SD 10.46) to 35.2 (SD 9.7), while those who did not listen to music (n=81) reduced their anxiety score from 36.23 (SD 10.54) to 35.1 (SD 10.59); the difference between the groups was statistically significant (t=1.95, df 161, p=0.05). Pulse achieved a statistically significant reduction in the music group (t=2.45, df 167, p=0.02). Music is a noninvasive nursing intervention that patients enjoy and reduces their anxiety and their pulse rate. Further research should address using music to reduce anxiety in other interventional vascular angiography settings with equal numbers of men and women and comparing self-selected versus investigator-selected music.
