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Learning Objective 1: Identify that intra-abdominal hypertension increases the morbidity and mortality of the critically ill patient.
Learning Objective 2: Relate the effects of nursing activities on the intra-abdominal pressure of patients at risk for intra-abdominal hypertension as identifed in this study.
Introduction/ Background: Past nursing research has identified that nursing activities can have a deleterious effect on the physiological parameters of critically ill patients. It is not known whether nursing activities have any effect on the intra-abdominal pressure (IAP) of patients at risk for intra-abdominal hypertension (IAH).
Theoretical Framework: Katharine Kolcaba’s comfort theory
Methods: Thirty-four critically ill adult patients who met the World Society of the Abdominal Compartment Syndrome’s criteria for IAP monitoring were enrolled in the study. A complete bed bath, including oral hygiene, a one-minute backrub and a full linen change was provided to each patient. The IAP was measured at rest prior to the bath, immediately after the bath, and 10 minutes later.
Results: There were 53 %( 18) female and 47 %( 16) male patients enrolled in the study. Twenty-eight patients required ventilator support. The mean age was 62.24+17.66.
Repeated-measures ANOVAs was used to compare between pre, immediate post, and 10 minute post complete bath for the normally distributed mean arterial pressures (MAP) and abdominal perfusion pressures (APP). There was a statistically significant difference among the MAP measurements p =.045. Post hoc testing found a statistically significant difference between pre and immediate post bath p=.045.
IAP was compared using Friedman test due to non-normally distributed 10 minute post-bath. There was a statistically significant difference p < .005. Post hoc testing found a statistically significant difference between the pre-bath IAP(Md=9.50) reading and the 10 minute post bath IAP(Md=7.5) reading, p < .005, and the immediate post bath IAP (Md=8.0) reading and the 10 minute post bath (Md=7.5) reading p = .003, (with a medium effect size of r=.30).
Conclusions: The significant drop in IAP measures post hygiene care indicates that it is safe to perform this nursing activity to patients at risk for IAH.
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