Date of Award
Projects: Open Access
Doctor of Nursing Practice (DNP)
Title: Increasing Pulmonary Artery Catheter Education Among CCU Nurses: A Quality Improvement Project
Background and Significance: Among the patient population in the Cardiac Care Unit (CCU) at a large academic medical center in Seattle, pulmonary artery (PA) catheters are commonplace. PA catheters are invasive central venous access devices with the ability to measure hemodynamic parameters that reveal information about the functionality and cardiac output of the heart. Should values obtained from PA catheters be incorrectly measured, serious complications could arise. Appropriate management of this device requires specialized expertise which is usually limited to cardiac critical care and surgical settings.
Problem and Purpose Statement: Multiple studies report mismanagement of PA catheters and incorrect measurement of the values derived from them in the absence of a specialized education program. Sufficient evidence supports the effectiveness of content-specific training for improvement of PA catheter knowledge. The CCU at this healthcare facility does not have a routine ongoing education program specifically dedicated to PA catheter management after the initial onboarding educational process for nurses. The primary aim of this program is to determine whether knowledge increases among CCU nurses who participate in a PA catheter training program. A secondary aim of the project is to evaluate the effectiveness of the developed PA catheter training program itself.
Methods: A PA catheter educational training program and an identical pretest and posttest were developed from published or validated resources and test questions. Concepts covered in the module includes expected standards of care, a brief overview of the basics of PA catheter management, the process of measuring hemodynamic values, and the mechanics of measuring end-expiration and its significance. Test questions for the pre- and posttest that demonstrated knowledge of the aforementioned topics were chosen. Ten CCU charge nurses participated in the pretest, intervention, and posttest. Tests were scored and compared to assess change in knowledge. Descriptive statistics of the paired data were calculated and analyzed quantitatively for change.
Results/Outcomes: Significant improvement was recognized after participants engaged in the educational program. The mean test score increased, answer variability decreased, and a p-value of 0.01 resulted demonstrating statistical significance. This effectively demonstrates that CCU nurse knowledge of PA catheters and their management improved. Inaccurate measurement of hemodynamic values obtained from a PA catheter is associated with increased mortality in critically ill patients (Claure-Del Granado & Mehta, 2016).
Sustainability: Promoting sustainability, this program will be used to educate nurse ‘super-users’. Since the implementation of the project, interdisciplinary interest has been expressed. Further aims are to educate a wider array of health professionals including physicians, advanced practice nurses, and physician assistants. In addition to the efficacy of the intervention, this educational program is inherently valuable within this healthcare facility due to the lack of published and scholarly resources dedicated to PA catheters.
Implications: Increased PA catheter knowledge among project participants indicates not only that the program content itself was efficacious at educating nurses; it also demonstrates that the educational program will likely be successful at educating other interdisciplinary staff in the CCU as well. The results also imply patients will receive safer and more effective care, thus improving patient care outcomes.
Fisher, Kayla Marie RN, BSN, "Increasing Pulmonary Artery Catheter Education Among CCU Nurses: A Quality Improvement Project" (2023). Doctor of Nursing Practice (DNP) Scholarly Projects. 59.