Other Titles

Nurses Removing Arterial Sheaths: A Quality Improvement Project [Title Slide]

Abstract

Introduction: Arterial sheaths are vital to many minimally invasive cardiac procedures. Nurses have performed arterial sheath removal after cardiac procedures in critical care settings for over a decade (Sania et al., 2022). Nurses removing arterial sheaths is associated with improved patient safety outcomes, including decreases in hematoma formation and awareness of risk factors (Al-Lenjawi et al., 2022; Henedy & El-Sayad, 2019). Removal of arterial sheaths is an advanced skill that requires nurses to meet specific criteria and receive clinically appropriate education (Capasso et al., 2006). Preparing experienced nurses to remove arterial sheaths earlier can increase patient safety and decrease complications. This project aimed to decrease hematoma rates by preparing nurses to perform arterial sheath removals through the dissemination of education and return demonstration of skill (Ghods et al., 2022; Jakobsen et al., 2022; Jalili et al., 2015; Sania et al., 2022).

Methods: A group of expert nurses in the CCU and CVICU with a minimum of one year of experience participated in a live education session. Pre- and post-Qualtrics surveys measured knowledge change. Aggregate data on patient hematomas was evaluated for two weeks pre-implementation and 12 weeks post-implementation of the educational session.

Results: Hematoma rates decreased from 20% (1 of 5 open hearts) to 0% (0 of 8 open hearts) post the implementation of the education session. On a pre-test, the nurse participants scored 6-12 out of a maximum score of 20, with a mean score of 10.4 (95% CI [7.93, 12.92], SD 2.70). After the education, participants scored between 12-20 with a mean post-test score of 16.9 (95% CI [14.27, 19.44], SD 2.79). This represented an increase of 32.14% from the pre- to post-knowledge tests. The education session had a 93% overall average positive evaluation score.

Conclusion: The results of this project indicate that providing an educational session for nurses on arterial sheath removal can increase knowledge of the nurse at the bedside and patient safety. These findings indicate that the sessions could be replicated to include additional qualified nurses in this facility or other centers of critical cardiac care. Further research is needed to monitor the long-term clinical impact of this educational intervention.

Notes

References:

Al-Lenjawi, B., Kunjavara, J., Hassan, N., Mannethodi, K., Martinez, E., Joy, G. V., & Singh, K. (2022). Evidence-based practice among critical care nurse’s/midwives in Qatar. Open Journal of Nursing, 12(1), 42-59. 10.4236/ojn.2022.121004

Capasso, V. A., Codner, C., Nuzzo-Meuller, G., Cox, E. M., & Bouvier, S. (2006). Peripheral arterial sheath removal program: A performance improvement initiative. Journal of Vascular Nursing, 24(4), 127-132.doi.org/10.1016/j.jvn.2006.09.001

Ghods, A. A., Roshani, A., Mirmohammadkhani, M., & Soleimani, M. (2022). Effects of valsalva maneuver on pain and vasovagal reaction during the removing of femoral arterial sheath after percutaneous coronary intervention: A randomized controlled Trial. Journal of Perianesthesia Nursing, 37(6), 900-906. https://doi.org/10.1016/j.jopan.2022.01.016

Henedy, W. M., & El-Sayad, H. E. S. (2019). Nurses’ knowledge and practice regarding patient’s safety post cardiac catheterization. IOSR Journal of Nursing and Health Science, 8(3), 43-52. DOI: 10.9790/1959-0803074352

Jakobsen, L., Holm, N. R., Maeng, M., Thim, T., Kristensen, S. D., Mogensen, L. H., & Christiansen, E. H. (2022).Comparison of MynxGrip vascular closure device and manual compression for closure after femoral access angiography: A randomized controlled trial: The closure devices used in every day practice study, CLOSE-UP IIItrial. BMC Cardiovascular Disorders, 22(1), 68. https://doi.org/10.1186/s12872-022-02512-0

Jalili, M., Imanipour, M., Nayeri, N. D., & Mirzazadeh, A. (2015). Evaluation of the nursing students’ skills by DOPS.Journal of Medical Education, 14(1). https://doi.org/10.22037/jme.v14i1.9069

Sania, S., Nazly, A., & Siddiqui, S. (2022). Effectiveness of standardized nursing care protocol among post cardiac catheterization patients to reduce hematoma development. Journal of Pharmaceutical Research International 34(39A): 49-58.

Description

Nurses removing arterial sheaths is associated with improved patient safety outcomes. This project prepared experienced nurses to perform arterial sheath removal. Results after intervention found nurse knowledge increased and patient hematomas decreased.

Author Details

Vanessa Rachel Roth, DNP, RN, CCRN-CSC-CMC; Lila de Tantillo, PhD, MS, APRN, FNP-BC

Sigma Membership

Lambda Rho at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Acute Care, Competence, Interprofessional, Interdisciplinary, Arterial Sheath Removal, Sheath Removal, Cardiac Catheterization, Femoral Arterial Sheath Removal, Nursing Education, Cardiac Sheaths

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Nurses Removing Arterial Sheaths: Disseminating Evidence-Based Practices to Improve Patient Care

Seattle, Washington, USA

Introduction: Arterial sheaths are vital to many minimally invasive cardiac procedures. Nurses have performed arterial sheath removal after cardiac procedures in critical care settings for over a decade (Sania et al., 2022). Nurses removing arterial sheaths is associated with improved patient safety outcomes, including decreases in hematoma formation and awareness of risk factors (Al-Lenjawi et al., 2022; Henedy & El-Sayad, 2019). Removal of arterial sheaths is an advanced skill that requires nurses to meet specific criteria and receive clinically appropriate education (Capasso et al., 2006). Preparing experienced nurses to remove arterial sheaths earlier can increase patient safety and decrease complications. This project aimed to decrease hematoma rates by preparing nurses to perform arterial sheath removals through the dissemination of education and return demonstration of skill (Ghods et al., 2022; Jakobsen et al., 2022; Jalili et al., 2015; Sania et al., 2022).

Methods: A group of expert nurses in the CCU and CVICU with a minimum of one year of experience participated in a live education session. Pre- and post-Qualtrics surveys measured knowledge change. Aggregate data on patient hematomas was evaluated for two weeks pre-implementation and 12 weeks post-implementation of the educational session.

Results: Hematoma rates decreased from 20% (1 of 5 open hearts) to 0% (0 of 8 open hearts) post the implementation of the education session. On a pre-test, the nurse participants scored 6-12 out of a maximum score of 20, with a mean score of 10.4 (95% CI [7.93, 12.92], SD 2.70). After the education, participants scored between 12-20 with a mean post-test score of 16.9 (95% CI [14.27, 19.44], SD 2.79). This represented an increase of 32.14% from the pre- to post-knowledge tests. The education session had a 93% overall average positive evaluation score.

Conclusion: The results of this project indicate that providing an educational session for nurses on arterial sheath removal can increase knowledge of the nurse at the bedside and patient safety. These findings indicate that the sessions could be replicated to include additional qualified nurses in this facility or other centers of critical cardiac care. Further research is needed to monitor the long-term clinical impact of this educational intervention.