Aaron Conway1, John Rolley2, Karen Page3, Paul Fulbrook4. 1. School of Nursing, Midwifery and Paramedicine (QLD), Australian Catholic University, Australia; Cardiac Catheter Theatres, The Wesley Hospital, Australia. Electronic address: awconw001@myacu.edu.au. 2. Cardiology Investigation Unit, St. Vincent's Hospital, Melbourne, Australia. 3. Heart Foundation. 4. National Centre for Clinical Outcomes Research, School of Nursing, Midwifery & Paramedicine (QLD), Australian Catholic University, Australia; Nursing Research and Practice Development Unit, The Prince Charles Hospital, Australia.
Abstract
BACKGROUND: Knowledge of current trends in nurse-administered procedural sedation and analgesia (PSA) in the cardiac catheterisation laboratory (CCL) may provide important insights into how to improve safety and effectiveness of this practice. OBJECTIVE: To characterise current practice as well as education and competency standards regarding nurse-administered PSA in Australian and New Zealand CCLs. DESIGN: A quantitative, cross-sectional, descriptive survey design was used. METHODS: Data were collected using a web-based questionnaire on practice, educational standards and protocols related to nurse-administered PSA. Descriptive statistics were used to analyse data. RESULTS: A sample of 62 nurses, each from a different CCL, completed a questionnaire that focused on PSA practice. Over half of the estimated total number of CCLs in Australia and New Zealand was represented. Nurse-administered PSA was used in 94% (n=58) of respondents CCLs. All respondents indicated that benzodiazepines, opioids or a combination of both is used for PSA (n=58). One respondent indicated that propofol was also used. 20% (n=12) indicated that deep sedation is purposefully induced for defibrillation threshold testing and cardioversion without a second medical practitioner present. Sedation monitoring practices vary considerably between institutions. 31% (n=18) indicated that comprehensive education about PSA is provided. 45% (n=26) indicated that nurses who administer PSA should undergo competency assessment. CONCLUSION: By characterising nurse-administered PSA in Australian and New Zealand CCLs, a baseline for future studies has been established. Areas of particular importance to improve include protocols for patient monitoring and comprehensive PSA education for CCL nurses in Australia and New Zealand.
BACKGROUND: Knowledge of current trends in nurse-administered procedural sedation and analgesia (PSA) in the cardiac catheterisation laboratory (CCL) may provide important insights into how to improve safety and effectiveness of this practice. OBJECTIVE: To characterise current practice as well as education and competency standards regarding nurse-administered PSA in Australian and New Zealand CCLs. DESIGN: A quantitative, cross-sectional, descriptive survey design was used. METHODS: Data were collected using a web-based questionnaire on practice, educational standards and protocols related to nurse-administered PSA. Descriptive statistics were used to analyse data. RESULTS: A sample of 62 nurses, each from a different CCL, completed a questionnaire that focused on PSA practice. Over half of the estimated total number of CCLs in Australia and New Zealand was represented. Nurse-administered PSA was used in 94% (n=58) of respondents CCLs. All respondents indicated that benzodiazepines, opioids or a combination of both is used for PSA (n=58). One respondent indicated that propofol was also used. 20% (n=12) indicated that deep sedation is purposefully induced for defibrillation threshold testing and cardioversion without a second medical practitioner present. Sedation monitoring practices vary considerably between institutions. 31% (n=18) indicated that comprehensive education about PSA is provided. 45% (n=26) indicated that nurses who administer PSA should undergo competency assessment. CONCLUSION: By characterising nurse-administered PSA in Australian and New Zealand CCLs, a baseline for future studies has been established. Areas of particular importance to improve include protocols for patient monitoring and comprehensive PSA education for CCL nurses in Australia and New Zealand.