Assessment and management of the anxious patient in the cardiac catheter laboratory

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Nurses in the cardiac catheter procedure environment provide care for patients undergoing investigation and intervention for diagnosis and treatment of heart disease. It is evident that such patients undergoing cardiac catheterisation will experience heightened anxiety. Consequently, psychological assessment should be incorporated throughout all aspects of nursing care in this setting. Routine assessment is important to enable early identification of patient anxiety and inform management strategies to be applied to best support the patient. However, there is evidence from across cardiac patient populations that anxiety is not routinely asse ssed in the acute care setting. Moreover, evidence supports that nursing assessment of anxiety may be unreliable and does not always reflect the patient experienced anxiety. The objective of this study was to utilise a qualitative approach to study nursing practices in regards to anxiety assessment and management when caring for patients undergoing cardiac catheter procedures. The study was undertaken from a single site cardiac catheter procedure unit in a large tertiary hospital. Data was collected through document analysis, chart review and semi-structured individual interviews with five cardiac nurses. This study found that nursing assessment and management of patient anxiety for patients in this setting was not clearly defined or actively implemented. The research also identified that there were negative outcomes for both patients and nursing staff when patient anxiety was not identified or managed in a timely manner. Unique organisational and cultural factors were found to influence these aspects of care in this environment. Findings also identified the need for a standardised approach to nursing assessment of anxiety and its subsequent management. Timely anxiety assessment and application of suitable nursing interventions to minimise patient anxiety are needed to yield positive outcomes for both patients and nursing staff. It is suggested that a suitable assessment tool to support standardised anxiety measurement be developed.