Abstract
Introduction
Radial compression (TR) bands are commonly used following coronary angiography, particularly in older adults. At a tertiary cardiac centre in South India, we observed significant delays in TR band removal, often exceeding two hours, contributing to discomfort, slower discharge, and risk of complications. Inconsistent documentation and unclear responsibility were key contributors. This quality improvement project (QIP) aimed to implement a 120-minute protocol to enhance efficiency, safety, and patient experience.
Method
Using NHS-aligned methodology and the Model for Improvement, baseline data from January to March 2024 revealed an average removal time of 142 minutes. In PDSA Cycle 1, we introduced a TR band register and conducted staff education sessions. In Cycle 2, visual prompts were added and staff ownership reinforced. Weekly removal times were tracked using a run chart, and a driver diagram guided interventions.
Results
By June 2024, average removal time decreased to 125 minutes. Documentation reliability improved from approximately 25% to over 90%. No increase in adverse outcomes such as bleeding or reapplication was noted. Staff reported improved clarity around roles and greater consistency in post-procedure care. The protocol was well accepted and sustained through integration into routine handovers.
Conclusion
Low-cost, system-level interventions, such as registers and team education, significantly improved procedural consistency and patient safety. This QIP highlights how structured, collaborative approaches can enhance post-angiography care, particularly for older adults, without requiring major resources.