| Autor: |
Espinosa, Teresa, Farrus, Anna, Venturas, Montserrat, Cano, Alba, Vazquez-Calvo, Sara, Pujol-Lopez, Margarida, Eulogio-Valenzuela, Frida, Guichard, Jean-Baptiste, Falzone, Pasquale V, Graterol, Freddy R, Freixa, Xavier, Tolosana, Jose M, Guasch, Eduard, Porta-Sanchez, Andreu, Arbelo, Elena, Brugada, Josep, Sitges, Marta, Mont, Lluis, Roca-Luque, Ivo, Althoff, Till F |
| Zdroj: |
EP: Europace; Apr2024, Vol. 26 Issue 4, p1-9, 9p |
| Abstrakt: |
Aims Same-day discharge (SDD) after atrial fibrillation (AF) ablation is an effective means to spare healthcare resources. However, safety remains a concern, and besides structural adaptations, SDD requires more efficient logistics and coordination. Therefore, in this study, we implement a streamlined, nurse-coordinated SDD programme following a standardized protocol. Methods and results As a dedicated SDD coordinator, a nurse specialized in ambulatory cardiac interventions was in charge of the full SDD protocol, including eligibility, patient flow, in-hospital logistics, patient education, and discharge as well as early post-discharge follow-up by smartphone-based virtual visits. Patients planned for AF ablation were considered eligible if they had a left ventricular ejection fraction (LVEF) ≥35%, with basic support at home and accessibility of the hospital within 60 min also forming a part of the eligibility criteria. A total of 420 consecutive patients were screened by the SDD coordinator, of whom 331 were eligible for SDD. The reasons for exclusion were living remotely (29, 6.9%), lack of support at home (19, 4.5%), or LVEF <35% (17, 4.0%). Of the eligible patients, 300 (91%) were successfully discharged the same day. There were no major post-SDD complications. Rates of unplanned medical attention (19, 6.3%) and 30-day readmission (5, 1.6%) were extremely low and driven by femoral access–site complications. These were significantly reduced upon the introduction of compulsory ultrasound-guided punctures after the initial 150 SDD patients (P = 0.0145). Standardized SDD coordination resulted in efficient workflows and reduced the total workload of the medical staff. Conclusion Same-day discharge after AF ablation following a nurse-coordinated standardized protocol is safe and efficient. The concept of ambulatory cardiac intervention nurses functioning as dedicated coordinators may be key in the future transition of hospitals to SDD. Ultrasound-guided femoral puncture virtually eliminated relevant femoral access–site complications in our cohort and should therefore be a prerequisite for SDD. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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