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Implementing Evidence-Based Practice Guidelines for Peripheral Artery Disease Screening with the Ankle Brachial Index for Asymptomatic High-Risk Patients
Bietau, Andrea R.
Bietau, Andrea R.
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Abstract
Background: There is a high prevalence of asymptomatic peripheral artery disease (PAD) and those with coronary artery disease (CAD) have an increased risk. Persons with PAD have many disadvantages including a worse prognosis and increased mortality. The American College of Cardiology and the American Heart Association recommend screening asymptomatic adult patients at risk for PAD with the ankle-brachial index (ABI).Purpose: The purpose of this project was to assess and increase the screening rate for PAD using the ABI among asymptomatic adult patients with known CAD at a cardiovascular clinic.Methods: This project was a pre-implementation design and used the Rosswurm and Larrabee change model. The setting was at a cardiovascular clinic in a suburban Midwest city. The population of interest were adults 18 years and older with known CAD. A retrospective review was performed to assess the screening rate for PAD among patients with known CAD. Champion cardiovascular providers then referred patients who had concomitant CAD for ABI screening if not previously obtained or without previous PAD diagnosis.Evaluation: A retrospective review of the last 100 patients who received either a percutaneous coronary intervention procedure or coronary artery bypass graft surgery revealed an ABI screening rate of 0.02%. Unfortunately, only one patient was referred for ABI screening during the implementation phase.Conclusion: The screening rate for PAD with the ABI among asymptomatic persons with CAD was low. Barriers to the implementation included a time barrier and lack of a pilot group. Continuation of this quality improvement project and future randomized controlled trials are needed.
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Date
2022-01-01
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University of Kansas
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This item contains archived web content.
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897636_1.pdf
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- Embargoed until 2172-05-31
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Keywords
Nursing, ankle brachial index, peripheral artery disease, screening