by Theresa Dunne, RN BSN MS, and Dana Roper-Effinger, RN MBA
Advisory Solutions

Radial artery access for cardiac catheterization is very popular in Europe and is slowly growing in popularity in the U.S. as patients learn about the procedure from the internet, friends and family members. What they are learning is there are a multitude of benefits to transradial procedures including improved patient safety, a more comfortable patient recovery and a decrease in overall cost for hospitals over femoral access procedures.

Femoral access procedures are the current standard of care in the United States with only 27% of all cardiac catheterization cases performed via the radial artery, according to a 2016 article in Diagnostic and Interventional Cardiology. Traditionally, the recovery for femoral access site catheterization requires compression of the femoral artery, which is performed by applying uncomfortable pressure by hand or with a clamp to the patient’s groin. To ensure proper hemostasis, patients need to lay on their backs for hours causing unnecessary discomfort and back pain. These inconveniences are eliminated when transradial access is chosen.

Transradial procedures offer patients the best possible outcomes, the highest patient satisfaction, the lowest readmission and fewer complications from risk of bleeding, according to a study in JACC: Cardiovascular Interventions. Patients know health care is a choice and prefer being able to recover sitting upright in a recliner. They are more satisfied with early ambulation, preservation of modesty and the general perception of a less invasive procedure.

Overcoming transition barriers with physicians and staff

While there is much to like about transradial access from a patient perspective, there is a documented learning curve, which can be a source of frustration for physicians and staff. It is imperative that leadership engage physicians and staff members in the transition to transradial. By doing so, all members of the team are educated on the benefits and will more readily embrace the change and overcome barriers.

Staff may be resistant with complaints of experiencing longer case times in the initial stages of the transradial procedure as well as decreased comfort with new technology. Engagement of staff and physicians calls for hospitals to make a commitment requiring both time and energy.

Honestly, change is hard. Sharing information on risks and benefits, development of a clear plan of engagement and execution, and transparent communication are the keys to a successful transradial program implementation.

To successfully implement and adopt a radial program, there needs to be commitment and dedication from both physicians and hospital administration. Successful program adoption requires hands-on courses, knowledgeable proctors, simulators and clinical support during transradial catheterization cases. Care pathways, best practices, radial lounges, and same-day discharge processes need to accompany a full radial access program and should be implemented along with education for physicians and staff.

Transitioning to radial access will help ensure patients have safer outcomes, fewer complications and higher patient satisfaction. To accomplish this, physicians must be given ample educational opportunities and be provided with information on cost, quality and outcomes of transradial access programs. When the transition program is well planned and any barriers are appropriately addressed, satisfaction for physicians, patients and staff can be assured.

For more information about how to develop a transradial access program in your facility, contact us.

About the authors. Senior Consulting Director Theresa Dunne and Consulting Director Dana Roper-Effinger help Vizient members reach their cost management, operational improvement and clinical alignment goals through a proven approach that focuses on members’ highest priorities to deliver desired results.

Published: September 28, 2020