Effects of Three Groin Compression Methods on Patient Discomfort, Distress, and Vascular Complications Post-Percutaneous Coronary Intervention

2.50
Hdl Handle:
http://hdl.handle.net/10755/160332
Type:
Presentation
Title:
Effects of Three Groin Compression Methods on Patient Discomfort, Distress, and Vascular Complications Post-Percutaneous Coronary Intervention
Abstract:
Effects of Three Groin Compression Methods on Patient Discomfort, Distress, and Vascular Complications Post-Percutaneous Coronary Intervention
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2005
Author:Chlan, Linda, PhD, RN
P.I. Institution Name:University of Minnesota
Title:Assistant Professor
Contact Address:School of Nursing, 5-160 Weaver-Densford Hall 308 Harvard, Minneapolis, MN, 55455, USA
Contact Telephone:612-624-6658
Co-Authors:Julie Sabo, MN, RN, CCRN, CS, Clinical Nurse Specialist and Kay Savik, MS, Biostatistician
Percutaneous coronary intervention (PCI) is a primary method for
treating coronary heart disease. Nurses use one of three groin compression
methods (GCMs) to achieve hemostasis after femoral sheath removal
following PCI; manual pressure, C-Clamp, and Femostop«. Patients report
mild-moderate discomfort with each GCM; vascular complications (VCs) vary
6-10%. While each GCM has benefits and limitations, no investigations have
examined all three simultaneously to determine which is superior. The
objective of this study was to determine which GCM following PCI is the
most comfortable, least distressful, and produces the fewest VCs.
A convenience sample of 306 PCI patients were recruited from one
Midwestern hospital for this three group experimental design study.
Participants were randomized to one GCM and rated their discomfort and
distress (0-10 scale) prior to sheath removal, 1 minute after compression
applied, 1- and 10 minutes after compression released. Groin assessments
for VCs (hematoma, ecchymosis, oozing) included prior to, 10-minutes
after, 12-, and 24 hours after sheath removal. Generalized estimating
equations (GEE) were used to detect any differences in discomfort,
distress, and VCs by GCM.
Participants' mean age was 62.3 (+/- 11.4) with a majority of males (77%;
females 23%). There were no differences in distress, discomfort or VCs by
GCM. Significant contributors to VCs included: baseline hematoma (z=-9.4;
p < .0001); baseline ecchymosis (z=-10.1; p < .0001) and Integrilin
(z=-3.0; p=.003); baseline oozing (z=-3.3; p=.001) and time to hemostasis
(z=2.6; p=.01).
While no specific GCM was found to cause less discomfort, distress or
fewer VCs, the presence of a VC prior to sheath removal, receipt of
anti-platelet medication, and longer time to hemostasis are contributors
to VCs. Nurses should be vigilant when providing care to PCI patients when
these factors are present.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffects of Three Groin Compression Methods on Patient Discomfort, Distress, and Vascular Complications Post-Percutaneous Coronary Interventionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160332-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Effects of Three Groin Compression Methods on Patient Discomfort, Distress, and Vascular Complications Post-Percutaneous Coronary Intervention</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Chlan, Linda, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Minnesota</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, 5-160 Weaver-Densford Hall 308 Harvard, Minneapolis, MN, 55455, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">612-624-6658</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">chlan001@umn.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Julie Sabo, MN, RN, CCRN, CS, Clinical Nurse Specialist and Kay Savik, MS, Biostatistician</td></tr><tr><td colspan="2" class="item-abstract">Percutaneous coronary intervention (PCI) is a primary method for <br/> treating coronary heart disease. Nurses use one of three groin compression <br/> methods (GCMs) to achieve hemostasis after femoral sheath removal <br/> following PCI; manual pressure, C-Clamp, and Femostop&laquo;. Patients report <br/> mild-moderate discomfort with each GCM; vascular complications (VCs) vary <br/> 6-10%. While each GCM has benefits and limitations, no investigations have <br/> examined all three simultaneously to determine which is superior. The <br/> objective of this study was to determine which GCM following PCI is the <br/> most comfortable, least distressful, and produces the fewest VCs.<br/> A convenience sample of 306 PCI patients were recruited from one <br/> Midwestern hospital for this three group experimental design study. <br/> Participants were randomized to one GCM and rated their discomfort and <br/> distress (0-10 scale) prior to sheath removal, 1 minute after compression <br/> applied, 1- and 10 minutes after compression released. Groin assessments <br/> for VCs (hematoma, ecchymosis, oozing) included prior to, 10-minutes <br/> after, 12-, and 24 hours after sheath removal. Generalized estimating <br/> equations (GEE) were used to detect any differences in discomfort, <br/> distress, and VCs by GCM.<br/> Participants' mean age was 62.3 (+/- 11.4) with a majority of males (77%; <br/> females 23%). There were no differences in distress, discomfort or VCs by <br/> GCM. Significant contributors to VCs included: baseline hematoma (z=-9.4; <br/> p &lt; .0001); baseline ecchymosis (z=-10.1; p &lt; .0001) and Integrilin <br/> (z=-3.0; p=.003); baseline oozing (z=-3.3; p=.001) and time to hemostasis <br/> (z=2.6; p=.01).<br/> While no specific GCM was found to cause less discomfort, distress or <br/> fewer VCs, the presence of a VC prior to sheath removal, receipt of <br/> anti-platelet medication, and longer time to hemostasis are contributors <br/> to VCs. Nurses should be vigilant when providing care to PCI patients when <br/> these factors are present.</td></tr></table>en_GB
dc.date.available2011-10-26T22:50:32Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:50:32Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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