Authors (including presenting author) :
Ng SKS (1)(2), Tsui KL (1), Yeung SFT (1), Leung MYI (1), Wan SK (1), Lam YF (1), Ng ML (1)
Affiliation :
(1) Department of Medicine, Pamela Youde Nethersole Eastern Hospital, (2) Hong Kong East Cluster
Introduction :
Echocardiography is a non-invasive technology to assess cardiac function. It provides real-time information to assist in diagnosis and treatment planning. It is commonly used to gather information before invasive procedures, identify complications and monitor treatment progress. Trained healthcare professionals could obtain echocardiographic images to enhance the patient care process.
Objectives :
Patient aspects
1. To identify and document the presence and haemodynamic significance of new pericardial effusion after electrophysiological procedures and PCI.
2. To assess the complications related to Acute Myocardial Infarction (AMI), such as mitral regurgitation (MR), free wall rupture, cardiac tamponade, shock, and heart failure.
3. To evaluate regional and global left ventricular (LV) function in cases of AMI.
4. To assess the intravascular volume in acute heart failure by measuring the diameter and collapsibility of the inferior vena cava (IVC).
Nursing aspects
1. To promote the advancement of nursing practice in cardiac care.
2. To equip nurses with the knowledge and skills to perform bedside-focused echocardiography, facilitating clinical services for managing cardiac patients.
Methodology :
The programme was started in June 2019. Nurses working in the Coronary Care Unit (CCU) received training from Consultant Cardiologists, which included 4 sessions of transthoracic echocardiography (TTE) theory, hands-on practice, and review of echocardiographic images and techniques. After the training, nurses performed TTE under cardiologist supervision. Once they completed the assessment, nurses were qualified to perform echocardiography independently.
Trained nurses screen TTE for newly admitted, deteriorating patients and those suspected of post-procedural complications. Regular meetings between cardiologists and nurses were held to review the echocardiographic images and discuss the clinical contexts. If nurses detect any suspected abnormalities, they promptly inform the physicians for further assessment.
Result & Outcome :
As of December 2024, 10 nurses (42% of the CCU nursing staff ) had completed the training. These nurses performed 100 to 180 echocardiography screenings annually. In 2024, we identified 4 cases that required immediate management.
Incorporating CCU nurses into echocardiography screening processes improves the early identification of potential complications in cardiac patients, resulting in better patient outcomes. This programme benefits patient care and promotes professional growth and skill development, contributing to a more versatile and competent workforce.
