Procedure videos to support rare clinical procedures in acute cardiac nursing, an implementation evaluation

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Central Coast Local Health District Research Grant. Background Cardiology procedures are often lifesaving and time-critical, but some are so infrequent that nurses may have rarely encountered them in practice. Videos demonstrating rare procedures can potentially support clinicians performing rare clinical procedures. We evaluated using locally created nursing clinical procedure videos as an adjunct to traditional written procedures. Purposes This study evaluated the implementation of 7 newly created clinical procedure videos on temporary cardiac pacing (n=3), non-invasive ventilation (NIV) (n=2) and pericardiocentesis (n=2). Methods A pre/ post -implementation Survey based on the Theoretical Domains Framework (TDF), Clinical Reasoning Cycle and the Spielberger State-Trait Anxiety Inventory (STAI) was distributed via email and Facebook groups to over 500 eligible nurses in the implementation sites. In addition, data from the hosting platform Vimeo for the implementation period and procedure numbers (15 October 2020 to 15 March 2021) were analysed. Results 122 respondents, 86% female, viewed the videos, mean age of 40.75 years (20 to 71 years). The most common procedure during the implementation period was NIV (n=170), followed by Pericardiocentesis (n=7) and Temporary Cardiac Pacing (n=5). The total number of video views over the 6 months was 598, temporary pacing-preparation (n=152), NIV Mask why and when (n=137), NIV Set up and Patient Care (n=89), Pacing: Procedure (n=62), Cardiac Tamponade (n=52), Pacing: Threshold testing and Pericardiocentesis Procedure (n=51 each). Participants agreed /strongly agreed that video procedures increased their recall (93.8%), made learning a better experience (98.3%), and was time-saving (88.0%) (Figure 2). Participants preferred videos to be an adjunct to existing written procedures and not a replacement (78%). Major themes from qualitative feedback included participants describing them as "clear and easy to understand" and the benefits of videos for rare procedures "Rarely seen in ED easy to follow and fast refresher when the procedure is time critical". Prior to implementation, the mean score for state anxiety before a rare procedure was 41.43 (SD= 9.307) with scores over 40 indicating clinically significant levels of anxiety. Older age and a higher number of years in the role were significantly correlated with lower anxiety levels (r = -0.144 p = .037; and r = 0.532 p = .000) perceived anxiety related to rare procedures did not significantly change from pre- to post-implementation. Conclusion Clinical procedure videos at the point of care are acceptable and valued. Findings suggest videos are a useful adjunct to written procedures for time-critical or rare procedures.Figure 2:Experience with video.