Document Type : Original Article(s)
Authors
1 Department of Medical Surgical, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
2 Assistant Professor, Department of Cardiology, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
3 Professor, Behavioral Science Research Center, Life Style Institute, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract
BACKGROUND: Evidence-based clinical care guidelines effectively assists medical teams to increase the quality of clinical practice, and improve outcomes in patients. This study aimed to design and implement evidence-based care guidelines for removing arterial sheath in patients undergoing angioplasty of coronary artery.METHODS: This clinical trial study was performed on 200 patients (two groups of 100 patients) with mean age of 62.5 ± 10.8 years, from July 2014 to February 2014 in Baqiyatallah University of Medical Sciences (BUMS), Tehran, Iran. First, we designed a five-step guideline for removing arterial sheath. Then, the designed guideline (based on five-step Stetler model, i.e. preparation, validation, comparative study, implementation, and execution) in the current study, and the routine guideline were used for removing arterial sheath in patients in the intervention and the control groups, respectively. In both groups, the relevant outcomes including bleeding, vasovagal reactions, urinary retention, and pain were evaluated.RESULTS: There were significant differences between the two groups in terms of bleeding, hematoma, vasovagal reactions (n = 11 versus n = 24), urinary retention (n = 8 versus n = 31), and back pain after removing arterial sheath (P < 0.050 for all).CONCLUSION: Based on the results of this study, the use of evidence-based care guidelines after removal of atrial sheath in patients undergoing angioplasty is recommended.
Keywords
- Harrison ER, Braunwald E, Jameson JL, Hauser S, Longo D. harrison's principles of internal medicine. New York, NY: McGraw-Hill, Medical Pub; 2005.
- Kabir K, Nojomi M, Motafaker M, Jamali A, Sadr Bafghi M. The Effect of Guality Improvement Program on In-Hospital Acute Myocardial Infarction Care in Afshar Hospital (Yazd-2004). Razi J Med Sci 2006; 13(50): 163-72. [In Persian].
- Grollman JH Jr, Liu CK, Astone RA, Lurie MD. Thromboembolic complications in coronary angiography associated with the use of nonionic contrast medium. Cathet Cardiovasc Diagn 1988; 14(3): 159-64.
- Khosravi A, Pourbehi MR, Pourmoghaddas M, Ostovar A, Akhbari MR, Ziaee-Bideh F, et al. Evaluating the impact of fractional flow reserve-guided percutaneous coronary intervention in intermediate coronary artery lesions on the mode of treatment and their outcomes: An Iranian experience. ARYA Atheroscler 2015; 11(2): 153-9.
- Khosravi A, Hoseinabadi M, Pourmoghaddas M, Shirani S, Paydari N, Sadeghi M, et al. Primary percutaneous coronary intervention in the Isfahan province, Iran; A situation analysis and needs assessment. ARYA Atheroscler 2013; 9(1): 38-44.
- Mann D, Zipes D, Libby P, Bonow R. Braunwald's heart disease: A textbook of cardiovascular medicine. Philadelphia, PA: Elsevier; 2014.
- Steed DL, Attinger C, Brem H, Colaizzi T, Crossland M, Franz M, et al. Guidelines for the prevention of diabetic ulcers. Wound Repair Regen 2008; 16(2): 169-74.
- Lia-Hoagberg B, Schaffer M, Strohschein S. Public health nursing practice guidelines: An evaluation of dissemination and use. Public Health Nurs 1999; 16(6): 397-404.
- Hewitt-Taylor J. Clinical guidelines and care protocols. Intensive Crit Care Nurs 2004; 20(1): 45-52.
- Vahedian-Azimi A, Ebadi A, Saadat S, Ahmadi F. Intelligence care: A nursing care strategy in respiratory intensive care unit. Iran Red Crescent Med J 2015; 17(11): e20551.
- Albert NM. Improving medication adherence in chronic cardiovascular disease. Crit Care Nurse 2008; 28(5): 54-64.
- National Collaborating Centre for Methods and Tools. Stetler model of evidence-based practice [Online]. [cited 2017]; Available from: URL: http://www.nccmt.ca/resources/search/83
- Rolley JX, Salamonson Y, Wensley C, Dennison CR, Davidson PM. Nursing clinical practice guidelines to improve care for people undergoing percutaneous coronary interventions. Aust Crit Care 2011; 24(1): 18-38.
- Galli A, Palatnik A. What is the proper activated clotting time (ACT) at which to remove a femoral sheath after PCI? What are the best "protocols" for sheath removal? Crit Care Nurse 2005; 25(2): 88-5.
- Jalali-Nia SF, Salsali M, Dehghan-Nayeri N, Ebadi A. Effect of evidence-based education on Iranian nursing students' knowledge and attitude. Nurs Health Sci 2011; 13(2): 221-7.
- Augustin AC, de Quadros AS, Sarmento-Leite RE. Early sheath removal and ambulation in patients submitted to percutaneous coronary intervention: A randomised clinical trial. Int J Nurs Stud 2010; 47(8): 939-45.
- Juergens CP, Lo S, French JK, Leung DY. Vaso-vagal reactions during femoral arterial sheath removal after percutaneous coronary intervention and impact on cardiac events. Int J Cardiol 2008; 127(2): 252-4.
- Capasso VA, Codner C, Nuzzo-Meuller G, Cox EM, Bouvier S. Peripheral arterial sheath removal program: A performance improvement initiative. J Vasc Nurs 2006; 24(4): 127-32.