Bed-rest post-femoral arterial sheath removal--what is safe practice? A clinical audit

Nurs Crit Care. 2005 Jul-Aug;10(4):167-73. doi: 10.1111/j.1362-1017.2005.00121.x.

Abstract

Numbers of patients undergoing coronary angiography and angioplasty procedures have increased in England due to targets within the National Service Framework for Coronary Heart Disease. Little evidence is available regarding optimal bed-rest duration for patients post-femoral arterial sheath removal following these procedures. Through literature review and clinical benchmarking, we aimed to identify what best practice was in the UK and whether bed rest times at our centre could be reduced without increasing complications to enable increased day case procedures. An audit tool was designed to collect data regarding method of obtaining haemostasis, length of bed-rest post-sheath removal and any post-procedural complications experienced by the patient. From a convenience sample of consecutive patients, 195 complete sets of baseline data revealed an average (median) period of 6-h bed rest. This was reduced to 3h and audit repeated yielding 176 complete data sets using the same audit tool. Femoral wound site complication rates were not significantly affected by reducing bed-rest time for diagnostic or interventional procedures. These findings contributed to an important change in practice, reducing length of stay post-procedure and should be re-explored due to increased use of femoral arterial closure devices.

Publication types

  • Evaluation Study

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Bed Rest / adverse effects
  • Bed Rest / methods
  • Bed Rest / nursing*
  • Bed Rest / standards
  • Benchmarking
  • Cardiac Catheterization
  • Coronary Angiography / adverse effects*
  • Early Ambulation
  • Evidence-Based Medicine
  • Female
  • Femoral Artery* / injuries
  • Follow-Up Studies
  • Hematoma / epidemiology
  • Hematoma / etiology
  • Hematoma / nursing
  • Hemostatic Techniques / instrumentation
  • Hemostatic Techniques / nursing
  • Hemostatic Techniques / standards
  • Humans
  • Male
  • Nurse's Role
  • Nursing Audit
  • Nursing Evaluation Research
  • Postoperative Care / methods
  • Postoperative Care / nursing*
  • Postoperative Care / standards
  • Safety Management
  • United Kingdom / epidemiology