A Written Procedural Information Tool to Increase Communication in Adult Patients Undergoing Cardiac Catheterization
January 2020
The prevalence of coronary artery disease (CAD) is steadily trending upward and is not predicted to decrease drastically in the near future. Currently, CAD contributes to 11.5% of overall deaths in the U.S. alone.1 Given this continued trend and the corresponding frequency of cardiac catheterization, measures to decrease patient anxiety and increase communication remain an ongoing need. Current literature indicates that 60% of adults experience increased levels of anxiety surrounding the cardiac catheterization procedure, which could potentially negatively impact their procedure outcome.2 This anxiety may be due to patient perception of the cardiac catheterization’s potential to be a life-threatening event, the uncertainty of their diagnosis, and their lack of knowledge and familiarity with the procedure process and environment.3-6 The highest level of anxiety occurs during the waiting period just prior to the procedure.6 Along with the expected high rate of anxiety comes a potential for the elevation of negative cardiac effects. The physiologic effects of anxiety affect cardiac muscle, including elevated blood pressure (BP) and heart rate (HR), and increased respiratory rate (RR), leading to a rise in oxygen consumption by the myocardium and increasing the demand on cardiac output. As a result, associated risks and angina can increase, with the potential to contribute to a negative outcome both at the time of the cardiac catheterization and during the recovery period.7 Evidence supports proper preparation of patients with information about their procedure as a way to reduce anxiety, increase post-procedure compliance, and enhance patient satisfaction.8 The potential negative outcomes of poor communication results in 10% of sentinel events and being uniformed rates highest on patient satisfaction complaints.8,9 While not all patients fully understand the pre-procedure education, when experienced personnel provide better quality information and present it in a format appropriate to the patient’s level of understanding, it results in improvements in patients’ perceived perception of communication, and reduced pain and anxiety.8,9 If improved communication results in better self-care, future medical interventions may be needed less frequently.8
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