Research On The Construction Of An Evidence-based PCI Preoperative Visit Model

Objectives1.To investigate the knowledge and attitudes of nurses in the cardiac catheterization lab regarding PCI pre-operative visits,in order to provide references for the construction of PCI pre-operative visits mode.2.To investigate the needs of patients undergoing percutaneous coronary intervention regarding PCI pre-operative visits and analyze its influencing factors,in order to formulate a new content combine the needs of patient.3.Based on evidence-based methodology combined with the needs of patients and nurses attitudes to construct a mode of PCI pre-operative visits,to provide reference for practice the PCI pre-operative visits.MethodsBased on JBI model of evidence-based healthcare,we used questionnaire survey to understand the knowledge and attitude of nurses in the cardiac catheterization lab regarding PCI pre-operative visits,and to grasp the needs of patients.By means of literature search,we analyzed the evidence of PCI pre-operative visits,and combined with the results of questionnaire survey,the first draft was completed by brainstorming,then we used Delphi to establish the standardized content of PCIpre-operative visits,and finally to construct the mode of PCI pre-operative visits.all data collected and analyzed by Excel 2013 and SPSS 22.0 statistical software.Results1.A total of 528 questionnaires of nurses in the cardiac catheterization lab were sent out,519 questionnaires were available and the response rate was 98.3%.The average score was(59.85+15.91),the overall pass rate was 64.16%,with nurse accuracy<50%for laboratory testing,medications prior to PCI,the purpose of intraoperative cooperation training,and ionizing radiation dosage.Knowledge scores were significantly associated with age,nurse professional titles,specialty nurse(p<0.05).88.44%thought it necessary to conduct PCI pre-operative visits,and 85.16%were willing to do so.Positive attitudes toward pre-operative visits were significantly associated with age and previous experience with PCI pre-operative visits(p<0.05).In addition,most nurses(94.22%)indicated that pre-operative visits training was necessary,the majority of nurses(65.92%)preferred visits the afternoon prior to PCI and the time should be controlled at 10?20 minutes(51.25%),the visits should be conducted by themself(41.04%),and suggested that the patient and family should be present,while 30.44%favored participation by both a doctor and a nurse.2.A total of 284 questionnaires of patients were sent out,271 questionnaires were available and the response rate was 95.4%.The The total score of needs for PCI patients was(145.76+21.20),the standardized score was 66.25.The standardized scores of each dimension from high to low were related expenses(90.13),psychological support(79.16),pre-operative preparation(74.40),pre-operative guidance(72.25),pre-operative visit form(65.70),surgical procedure(57.83),and environmental information(57.16).The top 10 items in demand were verbal education,informing the family how to accompany the day of PCI,encouraging language used by staff,stent price,intraoperative medication cost,intraoperative disposable materials cost,peer support,PCI start time,intraoperative coordination training,and combination of methods to per-operative visits.Multiple linear regression analysis showed that the total score of needs for PCI patients were associated with education,residence,medical insurance.3.Through literature search and quality evaluation,29 papers(12 in English and 17 in Chinese)were included,and 26 evidences were collected.Combining with the results of the previous questionnaire survey,the contents of PCI pre-operative visits were initially established.After two rounds of expert consultation,three first-level items including "pre-operative assessment","pre-operative education","pre-operative guidance",13 second-level items and 58 three third-level items were constructed.Considering with nurses' wishes,the mode of PCI pre-operative visits was finally constructed.Conclusions1.Nurses in the cardiac catheterization lab lacked the necessary knowledge but have positive attitudes regarding the practice of PCI pre-operative visits.Nursing managers should consider nurses' attitudes to organize standardized training for such visits to improve nurses' professional judgment and promote the efficient practice of PCI pre-operative visits.2.PCI patients have high demand of pre-operative visits,including strong demand for related costs,psychological support and other aspects.The practice of PCI pre-operative visits should followed demand-oriented,carry out diversified and humanized preoperative visits for different people,so as to improve the quality of pre-operative visits,and make the felling of patients better.3.The mode of PCI pre-operative visits based on evidence-based methodology,expert opinion,patient needs and nurse attitudes is scientific and reasonable,which can provide reference for the development and improvement of such visits.