Volume 3, Issue 1 (Winter 2016 -- 2017)                   JCCNC 2017, 3(1): 19-26 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Naseri Salahshour V, Sabzali Gol M, Basaampour S S, Varaei S, Sajadi M, Mehran A. The Effect of Body Position and Early Ambulation on Comfort, Bleeding, and Ecchymosis After Diagnostic Cardiac Catheterization. JCCNC. 2017; 3 (1) :19-26
URL: http://jccnc.iums.ac.ir/article-1-110-en.html
1- MSc of Nursing Education Student Research Committee, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
2- MSc. Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Karaj Branch, Islamic Azad University, Karaj, Iran. , msabzaligol@gmail.com
3- Ph.D. of Nursing Education, Academic member of Tehran University of Medical Sciences Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
4- Ph.D. of Nursing Education, Academic member of Arak University of Medical Sciences Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
5- Ph.D. of Biostatistics, Tehran University of medical sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:   (969 Views)

Background: Diagnostic cardiac catheterization is a common procedure in coronary artery disease. Patients’ movement and activities are limited because of potential risks; therefore, they need bed rest. The current study aimed at investigating the impacts of changes in body position and earlier ambulation on comfort, bleeding, and ecchymosis after the diagnostic cardiac catheterization.
Methods: The current clinical trial with quasi-experimental design included 90 patients undergoing diagnostic catheterization hospitalized in Shariati Hospital, Tehran, Iran. The purposive sampling method was used in the current study and subjects were allocated into 2 groups of intervention and control each of 45. The control group received the routine practices, the supine and flat rest for 8 to 24 hours, and sandbag for 8 hours. The intervention group changed their position in bed; first hour in flat position and head of bed in 15° and second hour in flat position and head of bed in 30°; then, in the 3rd hour in 45° position as well as applying sandbag on catheter entrance site for the first 3 hours; then, the patient was allowed to rest in any position (15° to 30°). Levels of comfort as well as the amount of bleeding and ecchymosis were studied immediately after the admission, 6 hours, 24 hours, and 7 days after the catheterization. Then, the results were analyzed using Chi-square and the Mann-Whitney tests with SPSS V. 11.5.
Results: There was no significant difference in the levels of comfort as well as the amount of bleeding and ecchymosis in early admission between the 2 groups, but the level of comfort was higher in the intervention group than the control group at the hours 6 and 24 after the catheterization (P < 0.001); in addition, there were no statically significant difference between the intervention and control groups in the amount of bleeding and ecchymosis at 6 hours, 24 hours, and 7 days after the catheterization (P = 0.99).
Conclusion: It was observed that patients may be allowed to change their bed position, and they may be ambulated earlier (the sixth hour) after the diagnostic cardiac catheterization. 

Full-Text [PDF 548 kb]   (287 Downloads) |   |   Full-Text (HTML)  (68 Views)  
Type of Study: Research | Subject: Special
Received: 2016/09/16 | Accepted: 2016/12/20 | Published: 2017/08/20

1. Alters, S. & Schiff, W., 2009. Essential concepts for healthy living. Massachusetts: Jones & Bartlett Publishers.
2. Bahr, R. D., 2000. The early heart attack care program, catheterization. Journal of Cardiovascular Diseases & Diagnosis, 53(3), p. 157.
3. Bakhshi, F., et al., 2014. Effect of positioning on patient outcomes after coronary angiography. Journal of Nursing Research, 22(1), pp. 45–50. doi: 10.1097/jnr.0000000000000020. [DOI:10.1097/jnr.0000000000000020]
4. Castillo-Sang, M., et al., 2010. Femoral artery complications after cardiac catheterization: A study of patient profile. Annals of Vascular Surgery, 24(3), pp. 328–35. doi: 10.1016/j.avsg.2009.06.025. [DOI:10.1016/j.avsg.2009.06.025]
5. Dabbs, A. D. V., et al., 1999. Nursing assessment of patient readiness for ambulation after cardiac catheterization. Medsurg Nursing, 8(5), p. 309. PMID: 10661169
6. Dowling, K., et al., 2002. Early ambulation after diagnostic angiography using 4-f catheters and sheaths: A feasibility study. Journal of Endovascular Therapy, 9(5), pp. 618-21. doi: 10.1583/1545-1550(2002)009 < 0618:eaadau > 2.0.co;2
7. Doyle, B. J., et al., 2006. Ambulation 1 hour after diagnostic cardiac catheterization: A prospective study of 1009 procedures. Mayo Clinic Proceedings, 81(12), pp. 1537–40. doi: 10.4065/81.12.1537. [DOI:10.4065/81.12.1537]
8. Dubey, L. & Sharma, S. K., 2012. Cardiac catheterization and complications: initial experience. Journal of College of Medical Sciences-Nepal, 8(2), pp.1-6. [DOI:10.3126/jcmsn.v8i2.6830]
9. Foji, S., et al., 2015. The study of the effect of guided imagery on pain, anxiety and some other hemodynamic factors in patients undergoing coronary angiography. Complementary Therapies in Clinical Practice, 21(2), pp. 119-23. [DOI:10.1016/j.ctcp.2015.02.001] [PMID]
10. Gall, S., et al., 2006. Rapid ambulation after coronary angiography via femoral artery access: A prospective study of 1,000 patients. Journal of Invasive Cardiology, 18(3), pp. 106-8. [PMID]
11. Hashemy, S. & Zakerimoghadam, M., 2013. Comparative study of the effect of muscle relaxation and music therapy on anxiety level in patients waiting for cardiac catheterization. Iranian Journal of Cardiovascular Nursing, 1(4), pp. 22-30.
12. Hinkle, J. L. & Cheever, K. H., 2013. Brunner and suddarth's textbook of medical-surgical nursing. Pennsylvania: Lippincott Williams & Wilkins.
13. Kato, F., et al., 2009. Reduction of bed rest time after transfemoral noncardiac angiography from 4 hours to 2 hours: A randomized trial and a one-arm study. Journal of Vascular and Interventional Radiology, 20(5), pp. 587–92. doi: 10.1016/j.jvir.2009.02.003. [DOI:10.1016/j.jvir.2009.02.003]
14. Layman, T. E., 1996. Reducing time in bed after cardiac catheterization (TIBS II). American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses, 5(6), pp. 462. PMID: 8811150
15. Lundén, M. H., Bengtson, A. & Lundgren, S. M., 2006. Hours during and after coronary intervention and angiography. Clinical Nursing Research, 15(4), pp. 274–89. doi: 10.1177/1054773806291855. [DOI:10.1177/1054773806291855]
16. Mohammady, M. et al., 2014. Early ambulation after diagnostic transfemoral catheterisation: A systematic review and meta-analysis. International Journal of Nursing Studies, 51(1), pp. 39–50. doi: 10.1016/j.ijnurstu.2012.12.018. [DOI:10.1016/j.ijnurstu.2012.12.018]
17. Nettina, S. M., 2013. Lippincott Manual of Nursing Practice. Pennsylvania: Lippincott Williams & Wilkins.
18. Rezaei-Adaryani, M., 2006. [The effect of position on back pain and bleeding after angiogeraphy (Persian)] (PhD dissertation). Tehran: Tarbiat Modares University.
19. Rosenstein, G., et al., 2004. Simple clinical risk stratification and the safety of ambulation two hours after 6 French diagnostic heart catheterization. The Journal of Invasive Cardiology, 16(3), pp. 126-8. PMID: 15152161 [PMID]
20. Sardarinia, M., et al., 2016. Risk factors for incidence of cardiovascular diseases and all-cause mortality in a middle eastern population over a decade follow-up: Tehran lipid and glucose study. PLOS ONE, 11(12), 0167623. doi: 10.1371/journal.pone.0167623 [DOI:10.1371/journal.pone.0167623]
21. Tengiz, I., et al., 2003. Six hour ambulation after elective coronary angioplasty and stenting with 7F guiding catheters ald low dose heparin. Kardiologia Polska, 58(2), pp. 93-7. PubMed ID: 14504634 [PMID]
22. Torabi, M., Salavati, M. & Sarabi, A. G., 2012. [Effect of foot reflexology massage and benson relaxation techniques on anxiety and physiological indexes of patients undergoing coronary heart angiography (Persian)]. Scientific Journal of Hamadan Nursing & Midwifery Faculty, 20(1), pp. 63-73.
23. Yilmaz, E., Gurgun, C. & Dramali, A., 2007. Minimizing short-term complications in patients who have undergone cardiac invasive procedure: A randomized controlled trial involving position change and sandbag. The Anatolian Journal of Cardiology, 7(4), pp. 390-7.
24. Zakeri-moghadam, M. & Hashemi, S. 2014. [Investigating the effect of Benson muscle relaxation on cardiac hemodynamic amounts in patients candidated for cardiac catheterization (Persian)]. Nursing Development in Health, 4(6-7), pp. 5-12

Add your comments about this article : Your username or Email:

Send email to the article author

Designed & Developed by : Yektaweb