Poster Presentation
Friday, 21 July 2006
10:00 AM - 10:30 AM
Friday, 21 July 2006
3:00 PM - 3:30 PM
This presentation is part of : Poster Presentations III
Optimal Bedrest Duration Following a Cardiac Interventional Procedure to Prevent Vascular Complications
Cynthia Honess, RN, MSN1, Gertrude Kent, RN, BSN, and Sara Kovacs, RN, BSN2. (1) Center for Clinical and Professional Development, Maine Medical Center, Portland, ME, USA, (2) Nursing, Maine Medical Center, Portland, ME, USA
Learning Objective #1: describe vascular complications arising from prolonged bedrest following a cardiac interventional procedure.
Learning Objective #2: verbalize adverse effects for the patient associated with prolonged bedrest following a cardiac interventional procedure.
Significance of the problem: What is the optimal bedrest duration to prevent vascular complications following a percutaneous coronary interventional (PCI) procedure? Confining patients to prolonged bedrest after PCI is in an effort to prevent bleeding at the femoral access site, and decrease risk of vascular complications, e. g. hematomas and pseudoaneurysms. Immobility potentiates patient problems such as back and leg pain, impaired urinary elimination, and abdominal discomfort. Prolonged bedrest-related problems can increase healthcare costs, and length of stay.
Search strategy: MEDLINE and CINAHL were indexed for research articles that (1) investigated duration of bedrest following a PCI, (2) French catheter size used for femoral artery access, (3) PCI catheter sheath dwell time, and (4) reported vascular complications. Five articles were found to review.
Evidence Synthesis and Integration: After article critique, integrated tables were developed. Evidence integration suggests the optimal bedrest duration following a femoral artery access for a PCI is not known. Femoral artery access sheath size may prolong time to hemostasis. Vascular complications may occur as the result of catheter sheath size, dwell time, and bedrest duration. Patient discomfort, such as back pain, leg stiffness, impaired elimination, and decreased gastric motility have been reported to be related to bedrest duration.
Outcome Evaluation: Current nursing care for patients following a PCI was examined based on findings from the integrated tables. A three month trial period has been completed during which four hours of bedrest was implemented, and vascular complication data was collected.
 Nursing Care Implications: Decreasing bedrest duration following femoral artery access for a PCI could increase patient comfort with early mobilization, decrease healthcare costs and length of stay.

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