Date of Paper/Work

5-2020

Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Gretchen A. Moen

Department/School

Doctor of Nursing Practice

Abstract

Coronary angiography is an invasive procedure that puts patients at risk for post-procedure complications, such as bleeding, which are associated with increased cost, length of stay, and mortality (Strauss et al., 2014). While intra- and post-procedure interventions have been utilized to mitigate risk of bleeding, a formal pre-procedure assessment has not been available until recently. The American College of Cardiology CathPCI Bleeding Risk Calculator is a validated tool that providers can use to calculate a bleeding risk score prior to coronary angiography (American College of Cardiology [ACC], 2017). This DNP project sought to determine if providing an educational program to advanced practice providers (APPs) on assessing bleeding risk using the ACC CathPCI Bleeding Risk Calculator would affect documentation of pre-procedure bleeding risk compared to standard practice. A pre-project implementation survey was given to the APPs to determine current standard of practice, attitudes toward risk scores, and openness to practice change. Education was also provided regarding factors that increase risk for post-procedure bleeding. During implementation, APPs calculated pre-procedural risk scores using the ACC CathPCI Bleeding Risk Calculator, communicated scores with patients and the interventional cardiologist, and documented risk scores in the consent note within the electronic medical record. Advanced practice providers were then surveyed to evaluate their experience with project elements such as formal bleeding risk assessment process and willingness to change practice. Results of the quality improvement project support the use of a formal process to document and communicate bleeding risk prior to the procedure, however providers were neutral about the usefulness and reliability of the bleeding risk calculator. Future projects are necessary to answer subsequent questions such as whether having the risk calculator changed the incidence of post-procedure bleeding events.

Available for download on Tuesday, May 31, 2022

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