Background Patients undergoing invasive diagnostic coronary angiography (DCA) for the first time often display high levels of anxiety at the time of their procedure as they are unfamiliar with the cardiac catheter laboratory set up. It is therefore part of the cardiac catheter laboratory staff′s role to reduce patient fears and hence improve their journey through the cardiac catheter laboratory. Several Cardiac centres have recently introduced radial lounges whereby patients feel less “hospitalised” by not needing to undress for their procedure.
Methods Following infection control approval, between mid-August 2010 and the end of October 2010, patients undergoing radial DCA at Salisbury District Hospital were offered the option of remaining clothed for their procedure. Each patient was given an information leaflet included in which was explained possible downsides to being dressed including if CPR were needed then clothes would be cut, failure of radial access and the subsequent need for femoral access, and the possibility of soiling the clothes with either blood or iodine. The only caveat stated was that female patients were not allowed to wear an underwire bra. Following their DCA, patients were then asked to fill in an anonymous questionnaire in which they were asked about their experience and whether not having to undress made them feel more relaxed.
Results 57 consecutive patients underwent (DCA) during this time period (100% uptake) with an average age of 68.1 ± 9.6 years. 71% were male and 21% (12/57) had undergone a DCA previously. Of these 12 patients 92% (11/12) stated that not having to undress was a good idea while an identical number felt much more relaxed than their previous DCA experience. Of the 45 patients that had not had a previous DCA, 96% (43/45) stated that not having to undress was a good idea while 96% (43/45) felt that this had made them feel very relaxed during their pathway. The other two patients felt that it made no difference. No patients required cross-over to femoral access and there were no blood or iodine stains on any clothes. Having patients remain dressed did not reduce fluoroscopic image quality and there were no issues with infection.
Conclusion Offering patients the option of having their radial DCA done without undressing is safe and helps to improve the patient journey through the cardiac catheter laboratory by making them feel more relaxed and less hospitalised. This is now standard at our Institution.
- Radial diagnostic coronary angiography
- patient journey
- remaining clothed