Document Detail


A randomised controlled trial to compare a nurse practitioner to medical staff in the preparation of patients for diagnostic cardiac catheterisation: the study of nursing intervention in practice (SNIP).
MedLine Citation:
PMID:  15053888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A number of initiatives have employed nurses in roles traditionally associated with the medical profession but few have been evaluated in prospective randomised studies. This paper reports the results of a randomised controlled trial to assess the performance of a nurse practitioner (NP), trained to prepare patients for diagnostic cardiac catheterisation. METHODS: Eligible and consenting patients were randomised to preparation by either the NP or junior medical staff (JMS). The safety outcome measure was the rate of in-hospital major adverse clinical events including death, myocardial infarction and emergency bypass coronary surgery. Other outcome measures included rate of minor adverse events, cardiologist assessment of case preparation and presentation, patient satisfaction and duration of pre-admission clinic. RESULTS: From April 1997 to May 1998 a series of 355 patients scheduled for elective, day-case, diagnostic cardiac catheterisation were screened. Of these, 345 patients were eligible for the study. A total of 339 patients consented to participate and were randomised. Major adverse clinical events occurred in 0/175 (0%) patients in the NP group and 2/161 (1.2%) patients in the JMS group. (Risk difference = -1.2%, upper boundary of the 95% confidence interval = +2.0%) The cardiologist's evaluation that the patient's preparation was acceptable was high in both groups: NP group 98.3% vs. JMS group 98.8%: P = 1.0). Patient satisfaction, assessed by questionnaire, was greater in the NP group (P = 0.04). The median duration of the pre-admission clinic visit was lower in the NP group 165 min vs. 185 min in the JMS group, P = 0.01). CONCLUSIONS: The preparation of patients for diagnostic cardiac catheterisation can be safely performed by an appropriately trained NP. This approach may be associated with improved patient satisfaction and reduced clinic duration times.
Authors:
R H Stables; J Booth; J Welstand; A Wright; O J M Ormerod; W R Hodgson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology     Volume:  3     ISSN:  1474-5151     ISO Abbreviation:  Eur J Cardiovasc Nurs     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-31     Completed Date:  2004-06-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101128793     Medline TA:  Eur J Cardiovasc Nurs     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM; N    
Affiliation:
Clinical Trials and Evaluation Unit, The Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK.
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MeSH Terms
Descriptor/Qualifier:
Clinical Competence / standards
Heart Catheterization / adverse effects,  nursing,  psychology,  standards*
Humans
Length of Stay / statistics & numerical data
Medical Staff, Hospital / standards*
Nurse Practitioners / education,  standards*
Nurse's Role
Nursing Evaluation Research
Outcome Assessment (Health Care)
Patient Satisfaction
Preoperative Care / methods,  nursing*,  psychology,  standards*
Prospective Studies
Questionnaires
Safety
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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