Date of Degree
12-2025
Document Type
Doctoral Project
Degree Name
Doctor of Nursing Practice (DNP)
Program
Nursing
Advisor
Karen Percell
Abstract
Background and significance of the problem: Pediatric congenital heart defect patients are amongst the sickest hospital population. These patients require planned palliation in the cardiac catheterization lab (cath lab), which has a limited number of providers and appointments available. In the cath lab, the percentage of avoidable same-day cancellations for interventional procedures was found to be greater than 30%, representing significant resource utilization opportunities.
Purpose: The purpose of this project was to develop and implement a standardized, evidence-based pre-procedure protocol to decrease avoidable same-day cath lab cancellations.
Goals and objectives: The goals of this project were a 10% decrease in same-day cancellations within 90 days of implementation and an overall decrease to less than 10% annually within one year of implementation.
Method/ key activities: This project was done using the Iowa Model of Evidence-Based Practice. A review of the evidence along with baseline assessment of existing patient data was completed to identify the appropriate activities. Five actions were identified to resolve the existing program deficiencies: 1. Case management. 2. Standardized care for all patients. 3. Multidisciplinary management. 4. Present state of health assessment. 5. Standardized patient education. Implementation was achieved by creating a patient tracker, creating a preprocedural protocol template for all patients, scheduling multidisciplinary meetings to review procedural patients, developing a pre-procedure patient assessment process and the creation and distribution of pre-procedure education packets for patients and their parents.
Results: 1. Case management- 100% of the multidisciplinary team members had access to the patient tracker. 2. Standardized care for all patients- weekly interventional nurse practitioner reviews were performed on 100% of patients and weekly registered nurse screenings were done on 94% of patients. 3. Multidisciplinary management- the multidisciplinary meetings had full attendance at 69% of scheduled occurrences and 100% of patients were reviewed. 4. Present state of health assessment- assessments were completed for 89% of patients. 5. Standardized patient education- 94% of patients/ families received pre-procedure education packets in a timely manner. Within 90 days of implementation, a 25% decrease in same-day cancellations for cardiac catheterization procedures was appreciated.
Implications for Practice: A standardized pre-procedure protocol to prepare patients for cardiac catheterization procedures can effectively decrease avoidable same-day cancellations. In a span of 90 days, 26 additional patients were able to receive their required cardiac intervention sooner than initially anticipated. The pre-procedure protocol allows previously unscheduled patients to fill schedule openings from early identified patient variants that once would not have been appreciated until the day of intervention, thus optimizing use of the physical environment and increasing access to the specialty services that are in many instances life-sustaining.
Keywords: cardiac catheterization, pre-procedure protocol, cancellations
Recommended Citation
Perry, Christina C., "Implementing a Cardiac Catheterization Pre-Procedure Protocol to Decrease Avoidable Same-Day Cancellations" (2025). Doctor of Nursing Practice. 131.
https://athenaeum.uiw.edu/uiw_dnp/131
First review - F. Lucille (Sia) Achica
CPerry_2ndRev_10-27.pdf (343 kB)