[New generation implantable loop recorders can be safely managed by certified nurses]. / I loop recorder impiantabili di nuova generazione possono essere gestiti in maniera sicura ed efficace da personale infermieristico formato.

. New generation implantable loop recorders can be safely managed by certified nurses. INTRODUCTION: Implantable loop recorders (ILR) are recommended for several cardiac disorders: the recent miniaturization processes eased their implant and management. AIM: To describe the advantages of the ILR implant, patients' education and remote control performed by expert certified nurses. METHODS: Retrospective analysis of consecutive ILR implants of our centre, preformed between May and December 2016: the complications occurred in patients implanted by doctors and nurses were described. Nurses were certified after a two days course and 3 implants assisted by a medical doctor. RESULTS: 157 patients were implanted with a ICM Reveal LINQ (Medtronic): 74 (47%) by physicians electrophysiologists and 83 (53%) out of the electrophysiology room, by certified nurses. The two groups of patients were not fully comparable because more complex patients were implanted by the physician. All the loop recorders were easily implanted adverse without events during the procedure and after 30 days. Two minor bleedings occurred 24 hours after the implant: 1 in a patient implanted by a physician and the other by a nurse. Both were rapidly solved by finger pressure. CONCLUSIONS: The ILR implants can be safely performed by trained nurses, out of the elettrophysiology room, with benefits for the patients and the hospital.

Atrial electrogram interpretation improves after an innovative education program.

BACKGROUND: To avoid adverse patient outcomes from inappropriate treatment, it is recommended that an atrial electrogram (AEG) be recorded whenever atrial arrhythmias develop in patients after cardiac surgery. However, AEGs are not commonly performed because nurses lack knowledge about differentiating atrial rhythms on AEGs. OBJECTIVE: To investigate whether completing a novel online evidence-based education program on interpreting AEGs would improve critical care nurses' AEG interpretation. METHODS: Specialized critical care nurses were taught about obtaining and interpreting atrial rhythms on AEGs using a 42-minute online mini-movie. AEG interpretation was assessed pre and two and eight weeks post-intervention. RESULTS: AEG interpretation increased two weeks post intervention and was retained at eight weeks. Some participants used this newly acquired knowledge to interpret arrhythmias that were not taught during the education program. CONCLUSION: Accurate interpretation of AEGs is an easy skill for specialized critical care nurses to learn via an online education program.

Procedimiento de actuación de enfermería en el estudio electrofisiológico cardíaco y en la ablación mediante radiofrecuencia / Nursing intervention procedure on cardiac electrophysiologic studies and radiofrequency catheter ablation", "_i": "

La atención sanitaria basada en la evidencia y su aplicación a través de las herramientas disminuye la variabilidad de la práctica clínica. Una de estas herramientas son los procedimientos, las cuales contienen las normas de calidad de proceso que definen las responsabilidades y las acciones que se deben llevar a cabo en una situación dada, orientan hacia la consecución de objetivos que garanticen la satisfacción del paciente como receptor de los cuidados y proporcionan al profesional seguridad y confianza para desarrollar sus actuaciones. Éstas constituyen un instrumento de trabajo preciso para conocer, controlar y mejorar el producto que generamos en forma de servicio y un respaldo institucional, legal y científico. El estudio electrofisiológico cardíaco y la ablación exigen una adecuada preparación protocolizada. Se presenta el procedimiento de actuación de enfermería en el Laboratorio de Electrofisiología del Hospital Universitario Virgen del Rocío.

Evidence based health care and its application by using different tools in order to reduce variability in clinical practice is essential nowadays. One of these tools are procedures. They contain process quality regulations which define responsibilities and actions to be taken, aim at the achievement of objectives to ensure the satisfaction of the patient as recipient of care, and give the professionals safety and confidence for carrying out their interventions. Such procedures are a necessary working tool to know, monitor, and improve the outcomes that we produce as a service and institutional, legal and scientific support. Cardiac electrophysiologic studies and radiofrequency catheter ablation demands an adequate protocolized preparation. Now, it is presented the nursing actuation procedure on Electrophysiologic Studies and Radiofrequency Ablation, in the Electrophysiology and Arrhytmia Unit (“Virgen del Rocio” University Hospital Seville).

Airway interventions in the cardiac electrophysiology laboratory: a retrospective review.

OBJECTIVE: To quantify the incidence of airway interventions during cardiac electrophysiology laboratory procedures. DESIGN: A retrospective chart review. SETTING: A tertiary care teaching hospital. PARTICIPANTS: Two-hundred eight adult patients undergoing cardiac electrophysiology laboratory procedures during a 2-year period, March 2006 to March 2008. The patients underwent the following procedures: supraventricular tachycardia ablation, atrial tachycardia ablation, atrial flutter ablation, premature ventricular contraction ablation, and ventricular tachycardia ablation. Patients who were intubated (in the intensive care unit or emergency department) before the ablation began, patients with ventricular assist devices or intra-aortic balloon pumps, and patients receiving inotropic support before the procedure were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The data were summarized by using the mean and standard deviation. Of the 208 patients, 186 were planned monitored anesthesia care, and 22 were planned general anesthetics. Of the monitored anesthesia care cases, 20 were converted to general anesthesia, and 54 received some type of airway intervention including oral-pharyngeal airway or nasal airway insertion. Therefore, 40% (74/186) of the non-general anesthesia cases required an airway intervention. CONCLUSIONS: These results suggest that a significant proportion of the authors' patients undergoing cardiac electrophysiology laboratory procedures required deep sedation if not general anesthesia, although a non-general anesthetic was planned. The issue of depth of sedation has implications for patient safety, privileging, and regulatory compliance. Based on the present results, the authors believe sedation for these procedures is best given by anesthesia providers; furthermore, caregivers should be aware that these procedures are likely to require deep sedation if not general anesthesia.

Relationship between nurse caring and patient satisfaction in patients undergoing invasive cardiac procedures.

Cardiac patients (N = 73) undergoing interventional cardiology studies reported perceptions of nurse caring and patient satisfaction with care. A moderately strong relationship (r = 0.53, p = 0.01) between caring and satisfaction was found. Male and female subjects did not differ on perceptions of caring and patient satisfaction. Since caring is considered fundamental to the nature of nursing, practicing nurses must appreciate its connection to outcomes, such as patient satisfaction.