Patients' experiences of cardiology procedures using minimal conscious sedation.

AIM: The study's purpose was to describe patients' experiences of minimal conscious sedation during diagnostic and interventional cardiology procedures. METHODS: Over a 6-week period, 119 consecutive patients (10% of annual throughput) from a major metropolitan hospital in Melbourne, Australia, were interviewed using a modified version of the American Pain Society Patient Outcome Questionnaire. Patients identified pain severity using a 10-point visual analogue scale and rated their overall comfort on a 6-point Likert scale ranging from very comfortable to very uncomfortable. RESULTS: Patients were aged 67.6 years (standard deviation 11.1), 70.8% were male, and the mean body mass index was 27.7 (standard deviation 4.8). Patients underwent diagnostic coronary angiography (67.5%), percutaneous coronary interventions (13.3%), or combined procedures (19.2%). Most patients (65%) were comfortable in the context of low-dose conscious sedation. Slight discomfort was reported by 26% of patients; 9% reported feeling uncomfortable primarily as a result of a combination of musculoskeletal pain, angina, and vasovagal symptoms experienced during the procedure. There was significant correlation (rho = .25, P = .01) between procedure length and patients' report of overall comfort, suggesting longer procedures were less comfortable for patients. CONCLUSIONS: The minimal sedation protocol was effective for the majority of patients; however, 9% of patients experienced significant discomfort related to preexisting conditions, highlighting the need for individual patient assessment before, during, and after the procedure.

Using reflective models to enhance learning: experiences of staff and students.

In this paper we reflect on a quality activity undertaken with students enrolled in a Bachelor of Nursing course who were required to write a 3000-word reflective paper for a unit called 'Nursing People Experiencing Long Term Illnesses.' Students were required to select one chronic illness from a list of five suggested by the teaching team. Having made their choice, they developed their paper in two parts. Students were first required to briefly discuss the pathophysiology of the illness, and its psychosocial effects on the individual and family. Second, they were required to use a model of reflection to discuss how knowledge they gained could be applied when working with a person with this condition, within the hospital and the community. Highlighted in this paper are the voices of 10 students who accepted an invitation to be involved in a focus group discussion which elicited their views, experiences and concerns regarding this assessment. Analysis revealed that students found the assignment topic to be challenging, rewarding and an appropriate vehicle to unveil what they learned. However, completion of the assessment was not without its difficulties. In this paper, insights gained in using this teaching and learning strategy are shared.