Clinical and procedural predictors of nurse workload during and after invasive coronary procedures: the potential benefit of a systematic radial access.
BACKGROUND
Invasive coronary procedures are increasing in number and complexity over time. This trend translates in an increased need for economical and human resources, among which is nurse staffing the most affected.


OBJECTIVE
To identify possible predictors of nurse workload, during and after diagnostic and interventional procedures.


METHODS
Two hundred and sixty consecutive patients were included: 52 and 208 patients underwent femoral and radial access, respectively. Nurse workload was calculated with a self-developed model.


RESULTS
Cathlab nurse workload was 103 [63--156] min. Independent predictors of increased Cathlab nurse workload were: femoral access, failed radial access and cross-over, interventional procedures, procedural time, urgent procedures. Cathlab nurse workload was 174 [134--218] and 86 [58--126] min, for femoral and radial access, respectively (p<0.001). Among the overall population, 174/260 patients (44 females, mean age 66+/-11 years) were hospitalised at our Center after the procedure. Fifty-six and 118 patients had femoral and radial access, respectively. Ward nurse workload was 457 [226--954] min. Independent predictors of increased Ward nurse workload were: access-site complication, length of in-hospital stay, admission to CCU, interventional procedures. Ward nurse workload was 386 [226--652] and 720 [314--1375] min, respectively for radial and femoral access (p<0.001).


CONCLUSIONS
A systematic radial access is an effective strategy for reducing nurse workload, both during, by simplifying nurse tasks in the CathLab, and after coronary invasive procedures, by preventing access-site complications, shortening in-hospital stays, and reducing admissions to CCU.
Amoroso
Giovanni
G
Cardiac Catheterisation Laboratory, Cardiothoracic Department, University of Pisa, Italy. gioamor@hotmail.com
Sarti
Mascia
M
Bellucci
Rita
R
Puma
Francesca Li
FL
D'Alessandro
Silvia
S
Limbruno
Ugo
U
Canova
Alessia
A
Petronio
Anna Sonia
AS
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000451:nursing*; D006328:Cardiac Catheterization / Q000379:methods / Q000451:nursing*; D003325:Coronary Care Units; D003327:Coronary Disease / Q000175:diagnosis* / Q000451:nursing* / Q000628:therapy; D005260:Female; D005263:Femoral Artery; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D011787:Quality of Health Care; D017534:Radial Artery; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016526:Workload