An evidence-based approach to reducing bed rest in the invasive cardiology patient population
- Wendy Vlasic, RN, MScN, CCN(C)
- Cardiac Care, London Health Sciences Centre London, Ontario, Canada
- evidence-based medicine
- heart catheterisation
- angioplasty (transluminal
- bed rest
In 2003, the Honour Society of Nursing, Sigma Theta Tau International and Nursing Spectrum sponsored an “Innovations in Clinical Excellence” contest to recognise exemplars of evidence-based nursing practice. The following 5 papers are winning entries, which are published with permission of the Honour Society of Nursing, Sigma Theta Tau International.
The most uncomfortable part of hospital admission for patients requiring coronary interventional and/or diagnostic procedures is the time required to lie flat after removal of the indwelling femoral arterial introducer sheath. Conventional practice required a minimum of 6 hours of supine bed rest after sheath removal, often resulting in the problem of back pain.
The Nurse Practitioner/Clinical Nurse Specialist (NP/CNS) for interventional cardiology targeted this problem for further investigation in 1994 and took the lead in determining the process and strategies to be used. A group of interested physicians and nurses was convened, reflecting the multidisciplinary interest in addressing this clinical problem.
TYPE OF EVIDENCE USED
The basis for the practice of prolonged bed rest was a mix of ritual, research, and expert opinion. The expert consensus was that prolonged bed rest was required to ensure adequate haemostasis at the femoral arterial puncture site. Research, much of it conducted by nurse researchers, had been gradually demonstrating the safety of …