Factors Contributing to temporary pacemake adverse events among critically ill cardiac patients

AbstractBackground: Temporary pacing is an emergency intervention used to manageinadequate cardiac output resulting from bradycardia. It delivers electrical stimulationto maintain an appropriate heart rhythm until a permanent pacemaker is implanted, orthe underlying condition is corrected, and it is essential for maintaining tissue perfusionin critical care settings. Aim: To determine the factors contributing to temporarypacemaker–related adverse events among critically ill cardiac patients. Setting: Thestudy was conducted in the coronary care units of Alexandria Main University Hospitaland Smouha General Hospital. Subjects: A convenience sample of 60 critically illcardiac patients, aged 18–65 years, who were admitted to the specified units andindicated for temporary pacemaker insertion, was included. In addition, approximately30 nurses providing direct care to these patients in the same settings participated in thestudy. Tools: Three tools were utilized. Tool I was the Cardiac Critically Ill Patient’sTemporary Pacemaker Assessment Record. Tool II was the Nurses’ KnowledgeRegarding Temporary Pacemaker Care Questionnaire. Tool III was the ObservationalChecklist for Coronary Care Nurses’ Practices Regarding Temporary Pacemaker Care.Results: The findings demonstrated that the most common adverse event related totemporary pacemaker was insertion site infection (25%), with a low rate of adverseevents related to the device. A statistically significant positive correlation was identifiedbetween nurses’ unsatisfactory levels of knowledge and practice (p<0.001) and theoccurrence of these adverse events. Conclusion: The study indicated that temporarypacing effectively manages complete heart block by improving hemodynamic stability.However, it also identified risks, including infection and lead dislodgement, associatedwith prolonged use of temporary pacemakers. Recommendations: Early transition topermanent pacemaker implantation, strict adherence to aseptic techniques, appropriatesecurement protocols, and enhanced nursing education are recommended to reducecomplications and improve patient safety and care outcomes. Develop and implementstandardized, evidence-based protocols for the insertion, monitoring, and removal oftemporary pacemakers to minimize practice variation and associated complications