Determining Best Nursing Practice: Effectiveness of Three Groin Compression Methods Following Cardiac Catheterization
Hanan Mohammed, Hanan Said and Manal Salah
Medical-Surgical Nursing Department, Faculty of Nursing, Ain Shams University,
Abstract: Cardiac catheterization is an extremely valuable procedure in diagnosis and treatment. However, few changes have occurred in the techniques used for percutaneous arterial cannulation, and for attaining homeostasis after cardiac interventions. Risks associated with femoral sheath removal include inadequate hemostasis leads to vascular complications. This may be costly, increase hospital time, and increase patient discomfort. Moreover, the process of sheath removal and femoral artery compression can be distressful, and affect patient satisfaction. This study was aimed at comparing the effectiveness of three groin compression methods (manual, bandage, and compressor) on patient vascular complications including (hematoma, ecchymosis and oozing), pain, and patient satisfaction following cardiac catheterization. A randomized clinical trial was conducted in cardiac catheterization and coronary Care Unites at National Institute of Heart. It included a sample of 150 patients admitted for performing cardiac catheterization via femoral artery randomly assigned to 3 equal groups: manual compression, bandage, and compressor. The tools used for data collection included Demographic and Clinical Data Sheet, scales for Hematoma Formation, ecchymosis, oozing, pain intensity and patient satisfaction procedure scale. The study maneuvers were applied according to the group. Groin sites were inspected immediately, at 6 and 12 hours post hemostasis. At 6 hours post hemostasis (70.0%) of patients in the manual group hadn’t hematoma formation compared to bandage and compressor groups (36.0% and 58.0% respectively) with statistically significant differences between the three groups. A statistically significant difference was revealed among the three groups at 12 hours post hemostasis, (P=0.001). It is evident that less patients in the manual group (6.0%) had large ecchymosis at 12 hours post hemostasis, compared to the compressor (20.0%) and bandage (24.0%) groups. Also at the same time, noticed that no one of patients in the three groups had severe oozing with no one of patients in the manual group had moderate oozing compared to compressor and bandage groups (2.0% and 12.0% respectively), and the difference was statistically significant, (P= 0.07).The bandage group had longer time for hemostasis (23.5±8.3 minutes) with more time of compression (144.9± 50.5 minutes) compared to the two other groups. The manual group had the lowest duration of bed rest (4.8±1.3 hours), and hospital stay (13.4±9.0 hours), compared to the other two groups, and the differences were statistically significant, (p<0.001). Additionally, manual group had the lowest scores of pain at all three assessment times (5, 10 and 20 minutes), whereas those in the compressor group had the highest scores. Overall, (80.0%) of the patients in the manual group were satisfied, compared to only (38.0%) in the compressor group, and (28.0%) in the bandage group. It is concluded that manual compression method after sheath removal in cardiac catheterization patients is associated with lower times of hemostasis and compression. It also has lower incidence of hematoma, ecchymosis, oozing with less pain.This reduction in vascular complications will in turn decrease time of bed rest and duration of hospitalization resulting in higher levels of patient satisfaction, compared to bandage and compressor device. Therefore, it is recommended to use this method, which does not need any special equipment, and is comfortable to the patient with develop a tool for ongoing measurements of patient outcomes upon post-arterial sheath removal.
[Hanan Mohammed, Hanan Said and Manal Salah. Determining Best Nursing Practice: Effectiveness of Three Groin Compression Methods Following Cardiac Catheterization. J Am Sci 2013;9(6):295-307]. (ISSN: 1545-1003).http://www.jofamericanscience.org. 35
Keywords: Cardiac catheterization, compressor, bandage, manual, hematoma, ecchymosis, oozing Full Text 35