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Am J Cardiol ; 118(12): 1842-1846, 2016 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-27771002

RESUMO

Sustained growth in the arrhythmia population at Stanford Health Care led to an independent nurse practitioner-run outpatient direct current cardioversion (DCCV) program in 2012. DCCVs performed by a medical doctor, a nurse practitioner under supervision, or nurse practitioners from 2009 to 2014 were compared for safety and efficacy. A retrospective review of the electronic medical records system (Epic) was performed on biodemographic data, cardiovascular risk factors, medication history, procedural data, and DCCV outcomes. A total of 869 DCCVs were performed on 557 outpatients. Subjects were largely men with an average age of 65 years; 1/3 were obese; most had atrial fibrillation; and majority of subjects were on warfarin. The success rate of the DCCVs was 93.4% (812 of 869) with no differences among the groups. There were no short-term complications: stroke, myocardial infarction, or death. The length of stay was shortest in the NP group compared to the other groups (p <0.001). In conclusion, the success rate of DCCV in all groups was extremely high, and there were no complications in any of the DCCV groups.


Assuntos
Assistência Ambulatorial/métodos , Fibrilação Atrial/terapia , Cardioversão Elétrica/métodos , Profissionais de Enfermagem , Padrões de Prática em Enfermagem , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/organização & administração , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Cardiomiopatias/epidemiologia , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Segurança do Paciente , Médicos , Estudos Retrospectivos , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Resultado do Tratamento , Varfarina/uso terapêutico
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