Clinical Nursing Practices Guideline from Evidence-Base for Endomyocardial Biopsy: Enhancing Nursing Roles post Heart Transplantation Care
Keywords:
Heart transplantation, Endomyocardial biopsy (EMB), Clinical nursing practice guidelines, Organ rejection, Evidence-BaseAbstract
Background: End-stage heart failure is a severe condition that significantly affects the quality of life of patients. Heart transplantation is an effective treatment to extend survival and improve the quality of life for these patients. Nonetheless, post-transplantation patients are substantial risk of organ rejection and various complications. Endomyocardial Biopsy (EMB) is the gold standard procedure for the evaluation and diagnosis of organ rejection after heart transplantation. Nurses’ roles in the management of patients undergoing EMB encompassing pre-procedural preparation, intra-procedural assistance, and post-procedural surveillance. Notwithstanding its significance, there exists a notable deficiency in evidence-based nursing practice guidelines tailored specifically to the context of Thailand, which may diverge from that of developed nations in terms of available resources and healthcare infrastructure.
Objective: To synthesize evidence-based nursing practices for patients undergoing endomyocardial biopsy (EMB) following heart transplantation.
Material and methods: A systematic literature review was conducted following the Joanna Briggs Institute (JBI) methodology, analyzing international studies published between 2020 and 2024. The objective was to formulate thorough nursing guidelines that are adapted to unique healthcare.
Results: Three principal phases of nursing care were delineated: 1) pre-procedural preparation, which encompasses patient education risk assessment and pain management; 2) intra-procedural care involving the preparation of equipment, monitoring of vital signs, and utilization of technology to enhance patient safety; and 3) post-procedural care concentrating on the monitoring of complications, providing self-care guidance, and planning follow-up care.
Conclusion: The synthesis of these guidelines highlights the importance of developing evidence-based nursing practices to enhance care quality, reduce complication risks, and support patient and caregiver engagement in the self-care process. The results can be applied in clinics to improve the standard of care for post-heart transplant patients undergoing EMB.
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