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theses

Purpose: The American College of Cardiology 2012 cardiac catheterization guidelines recommend bedrest for one to two hours for 4 to 5-French sheaths and two to four hours for 6 to 8-French sheaths. Research supports that raising the head of bed (HOB) to 60 degrees after one hour and ambulation after two hours of bedrest is safe for transfemoral diagnostic cardiac catheterizations with manual sheath removal. In winter 2018, an academic medical center piloted a quality improvement project to reflect this practice guideline. Methodology: A 2017 database was used to retrospectively obtain control findings on the prior bedrest practice involving four-hours bedrest and HOB no greater than 15 degrees. The intervention group was a convenience sample and collected information on groin complications, discharge times, and patient satisfaction for all patients who met the reduced bedrest protocol criteria. Descriptive statistics, t-tests, Kruskal-Wallis, and chi-square statistical tests were used to analyze the data. Results: The control group had 2 hematomas and intervention group had no groin complications, χ(1) = 2.53, p = .11. The length of stay in minutes was significantly different for the control group (M = 283, SD = 55.3) and intervention group (M = 184, SD = 57); t(285) = 15.3, p < .01. There were statistically significant increases in patient experience related to pain (t(27) = -2.45, p = 0.02) and procedural delay (t(27) = -2.73, p = .01). Implications for Practice: This cardiac catheterization department optimized its utilization of recovery space and procedural costs while improving patient satisfaction and maintaining safe outcomes. Future research will identify best practices for bedrest following closure devices and percutaneous coronary interventions.

ETD_9409

doi:10.7282/t3-1201-vm67

DNP

Includes bibliographical references

ETD doctoral

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