Using Innovative Thinking To Improve The Incidence of Bruising at The Puncture Site of Transradial Cardiac Catheterization

Hsu, Chien-Yunh ； Kuo, Ya-Ling ； Chen, Li-Hsueh ； Wang, Yu-Hsia

《The Proceedings of the 8th AHLA International Conference: Health Literacy in Social Resilience》 2022 (2022/12) Pp. 135-135

https://doi.org/10.30181/AHLA.202210.0087

摘要

BACKGROUND: When the literature indicates that transcatheter arterial catheterization is performed, Place arterial catheter to monitor hemodynamic changes and collect blood samples, Radial artery is often chosen as catheter access. Because of its anatomical location it is easy to perform pressure hemostasis with observation, Improper pressurization, Mild to cause bruising and hematoma at the puncture site, In severe cases, arterial vasospasm may occur, thrombus, and occlusion. Comorbidities such as arteriovenous fistula or pseudoaneurysm, Increase patient pain and discomfort, Even caused medical controversy due to vascular necrosis.
OBJECTIVE: Incidence of bruising at the puncture site after cardiac catheterization in 2021 ,number of people 10 of 8.5%,The target value of referring to foreign literature is 6%,Reduced abnormal cardiac catheterization rate to 4%,and shorten the length of hospital stay,Reduce healthcare costs.
METHOD: The main reason for the occurrence of bruises is Physician puncture technique is not uniform, Poor hemostatic equipment, Nursing staff health education is not really caused. Suggested improvement measures are:1. To formulate health education standards for radial artery cardiac catheterization.2. Innovative hemostatic device.3. Formulate technical standards for radial artery catheterization and puncture and health education video. 4. Added screening for high risk groups for bleeding, Develop a screening form for high-risk groups of bruises.
RESULT: The incidence of bruising after cardiac catheterization decreased from 8% to 0% after implementing the method, Hospitalization days decreased by 0.2 days, Each person's health insurance medical consumption saves 743 yuan.
CONCLUSION: Cardiac catheterization before, during and after clinical examination will affect the severity of the disease due to comorbidities, Using innovative thinking to improve the puncture site of transradial cardiac catheterization, Not only reduces the incidence of bruising at the puncture site、Improve patient satisfaction, Significant improvement in pain and cyanosis，Promote inter-departmental teamwork, Improve patient safety and quality of medical care.