Show simple item record

dc.contributor.authorEndicott, K.M.
dc.contributor.authorDrucker, C.B.
dc.contributor.authorOrbay, H.
dc.contributor.authorDuBose, J.J.
dc.contributor.authorNagarsheth, K.
dc.contributor.authorToursavadkohi, S.
dc.contributor.authorSarkar, R.
dc.date.accessioned2020-01-16T14:39:56Z
dc.date.available2020-01-16T14:39:56Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85074871396&doi=10.1177%2f1538574419886193&partnerID=40&md5=0c02d6c702ca498674772fe8e37f456f
dc.identifier.urihttp://hdl.handle.net/10713/11638
dc.description.abstractBackground: Expanded applications and increasing volumes of complex endovascular procedures have increased the risk of unintended intraoperative fragmentation and retention of catheters and sheaths. We describe a series of retained or fragmented endovascular devices, a quality improvement program to address this unmet need for improved detection of catheter fragmentation, and the results of this program. Methods: Cases utilizing endovascular devices that resulted in a retained catheter fragment were identified and analyzed during divisional quality improvement review. One consistent area of concern was operating room (OR) staff unfamiliarity with verifying the integrity of an endovascular device. In response, a slide-based training protocol of focused, endovascular nursing education was implemented. Following perceived lack of improvement after this approach, we developed a handheld visual reference display of the tips of common catheters and sheaths. Staff was surveyed before and after intervention to assess the educational value of the display and the impact on staff device familiarity. Results: All 4 described cases resulted in an unplanned return to the OR for retrieval of the fragmented catheter or sheath. No thromboembolic complications were observed, although associated intra-arterial thrombus was noted in 2 cases. Thirty-four OR nurses were polled to trial the visual reference display initiative, with 70% of those reporting primary surgical assignments outside of cardiovascular ORs. Introduction of the new visual reference display improved staff confidence in their ability to identify a broken device (2.4-3.7, P <.001). This improvement was most significant in OR staff with primary assignments in noncardiovascular services. Conclusion: Current OR standard operating procedures fail to address the potential for unintentionally retained catheters and wires during endovascular procedures. Our novel visual reference display of common endovascular items rather than conventional in-service training improved the ability of staff to identify device fragmentation at the time of the index procedure. Copyright The Author(s) 2019.en_US
dc.description.urihttps://doi.org/10.1177/1538574419886193en_US
dc.language.isoen_USen_US
dc.publisherSAGE Publications Inc.en_US
dc.relation.ispartofVascular and Endovascular Surgery
dc.subjectendovascular proceduresen_US
dc.subjectnursing educationen_US
dc.subjectquality improvementen_US
dc.subjectretained foreign bodyen_US
dc.titleIntraoperative Fragmentation and Retention of Endovascular Devices: Clinical Consequences and Preventative Strategiesen_US
dc.typeArticleen_US
dc.identifier.doi10.1177/1538574419886193
dc.identifier.pmid31690248


This item appears in the following Collection(s)

Show simple item record