Determin
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):274-285].
(ISSN: 1545-1003).http://www.jofamericanscience.org. 32
Keywords: Cardiac catheterization, compressor, bandage, manual,
hematoma, ecchymosis, oozing Full Text 32
