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Preventing Radial Artery Occlusion by Using Reverse Barbeau Assessment: Bringing Evidence-Based Practice to the Bedside.

www.ccnonline.org CriticalCareNurse Vol 35, No. 4, AUGUST 2015 77 The traditional approach to percutaneous coronary angiography and intervention (PCI) is by femoral artery access. However, in recent years, a paradigm shift has occurred in catheterization laboratories across the nation: transradial PCI. In 2007, only 1.3% of all PCIs done in the United States used the transradial approach. This percentage has now increased to more than 20%.1 This dramatic increase is chiefly due to higher patient satisfaction rates, reduced bed rest and recovery times, and a 78% lower risk for bleeding and vascular complications with transradial procedures than for the femoral approach.2 In 2008, the director of Women’s Heart Health, an interventional cardiologist, brought transradial PCI to our facility to offer patients, especially female patients, a safer PCI option. With femoral access, women have a higher risk of PCI bleeding complications than men have (2.86% vs 1.22%, P < .01).3 Transradial access reduces this risk to 1.1% for women and 0.67% for men.3 As of 2013, more than 30% of our facility’s PCIs are performed transradially (Figure 1). The importance of learning about both femoral and radial access has also expanded into periprocedural nursing. Nurses are required to incorporate evidence-based care for all patients before and after cardiac angiography and intervention. This article describes the nursing journey of identifying evidence-based best practices, developing education plans, and multiunit implementation of an important postprocedural assessment with transradial procedures, the reverse Barbeau test. Colleen Bonnett, RN-BC, BSN Nancy Becker, RN, MSN, CCRN Brenda Hann, RN, MBA, CCRC Annette Haynes, RN, MS, CNS, CCRN, CCNS Jennifer Tremmel, MD Preventing Radial Artery Occlusion by Using Reverse Barbeau Assessment: Bringing Evidence-Based Practice to the Bedside