The effect of changing position and early ambulation after cardiac catheterization on patients’ outcomes: A single-blind randomized controlled trial

Abstract 

Background

Cardiac catheterization is the gold standard diagnostic test for coronary heart diseases. In order to minimize the post-procedure complications, patients are restricted to prolonged bed rest that is always accompanied by fatigue and discomfort.

Objective

The aim of this study was to assess the effect of changing position and early ambulation on the level of comfort, satisfaction, and fatigue and on the amount of bleeding and hematoma after cardiac catheterization.

Participants

A sample of 70 patients, who had undergone a non-emergency 6-French cardiac catheterization via the femoral artery from September to November, 2006.

Methods

In a single-blind randomized controlled trial, each patient was randomly assigned to either the control or experimental group. The patients’ position in the experimental group was intermittently changed during the first 6h after catheterization. Seven hours after the procedure, they were allowed to be ambulated and to undertake their self care activities. A pillow was placed under the patients’ bodies. Patients in the control group were managed as routine; they were restricted to a 10–24h bed rest bed rest in supine position with the affected leg straight and immobilized and a sand bag on the puncture site for at least 8h. The levels of comfort, satisfaction and fatigue, and the amount of bleeding and hematoma were measured at regular intervals after the procedure.

Results

The patients in the experimental group had significantly higher comfort and satisfaction and lower fatigue levels than the control group at 3, 6, 8h and the next morning after catheterization (P<0.01). Changing patients’ position according to the current protocol in the experimental group produced no significant increase in the amount of bleeding and hematoma when compared with the control group (P>0.05).

Conclusion

The results of this study showed that the levels of comfort, satisfaction and fatigue after catheterization are related to the duration of bed rest and patients’ position in bed. Changing patients’ position accompanied by early ambulation after cardiac catheterization are associated with increasing comfort and satisfaction levels and decreasing the level of fatigue without increasing the amount of bleeding and hematoma.

Keywords: Coronary heart disease, Fatigue, Pain, Nursing care, Position, Cardiac catheterization