Education and Evaluation of Using Best Practices for Arterial Sheath Removals: A Quality Improvement Project

Abstract

Purpose: This quality improvement (QI) project aimed to assess providers’ perceived confidence level in performing transfemoral artery (TFA) access discontinuation using manual compression following an educational presentation. Background: Invasive coronary angiography (ICA) is the gold standard for diagnosing and treating coronary artery disease (CAD). Arterial access sites are necessary for ICA operators to evaluate coronary artery patency. The most common access site is the femoral artery but has associated vascular complications directly related to inadequate manual compression. Providers voice concern with inconsistent manual compression education resulting in low confidence and improper technique. Methods: Participating providers attended an educational session, “A Pressure Refresher: No Peaky, No Leaky,” regarding best practice recommendations for appropriate removal of the sheath after ICA to prevent vascular complications. To measure confidence level, a pretest and posttest were completed. The tests evaluated the effectiveness of the educational session by assessing participants’ perceptions of confidence levels. Results: There was a statistically significant improvement in confidence by 16.2% following the educational session. The test indicated that participants credited their increase in confidence to the information in the educational session. Based on the outcomes, providers need additional education on identifying and rectifying vascular complications. Conclusions: The “A Pressure Refresher: No Peaky, No Leaky” educational session to increase provider confidence in performing appropriate removal of the sheath after ICA to prevent vascular complications was statistically significant.