ACCELERATED TRANSFER TO THE CARDIOLOGY WARD AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION IN THE CARDIAC CATH LAB: NURSE-LED INITIATIVE TO MATCH CARE TO CONTEMPORARY PRACTICE

Abstract

Advances in technology and procedural approaches are contributing to the adoption of increasingly minimalist strategies for patients undergoing transcatheter aortic valve implantation (TAVI). The use of local anaesthesia, the avoidance of invasive monitoring lines, and the availability of lower profile devices, augmented by the raised awareness of the risks of rapid deconditioning of the frail elderly, creates opportunities for cardiovascular nurses to revisit historical post-procedure care. The purpose of this presentation is to report on a nurse-led initiative to operationalize the accelerated transfer to the cardiology ward of patients following transfemoral TAVI in the cardiac cath lab. We will discuss the rationale, planning and implementation of the project; we will highlight how we capitalized on the expertise of critical care nurses to provide mentorship to cardiology ward nurses while strengthening transition of care and patient safety. We will present the post-procedure nursing protocol informed by the unique needs of elderly TAVI patients. Lastly, we will report on the findings of the evaluation of the first year of implementation, the lessons learned, and recommendations for TAVI centres to match nursing expertise to the rapidly evolving needs of patients. Cardiovascular nurses have a unique opportunity to lead the transformation of the way we care for TAVI patients to reflect contemporary practice, and maximize nurses’ scope of practice and expertise.