Femoral-arterielle Schleusenentfernung von medizinischem Assistenzpersonal nach Herzkatheter : Implementierung und Evaluation eines strukturierten Schulungsprogramms

摘要

Vascular access site complications after cardiac catheterization are a significant cause of prolonged hospital stay and morbidity. In Germany arterial closure is either achieved by a physician performing manual compression (MC) or a vascular closure device (VCD) is applied. Our aim is to check if MC trained nurses achieve similar outcomes as physicians regarding complication rate. We established a 4 stage training program in MC for nurses at the cardiac unit. During the observational phase, MC was only performed by physicians. In the implementation phase, MC was either performed by a physician or a trained nurse. In-hospital vascular complications were prospectively assessed in 3503 consecutive cardiac catheterization procedures and a total of 180 MCs were performed by a trained nurse. Complication rates for MC by physician and MC by trained nurse were studied and a propensity score matching performed to make the treatment groups comparable. There is no difference regarding complication rates between trained nurses and physicians. Moreover, complication rates by trained nurses were as low as VCD complication rates. Our study shows that MC performed by trained nurses is an effective and safe alternative to MC performed by a physician.