The effect of evidence-based care guidelines on outcomes after removal of arterial sheath in patients undergoing angioplasty.

Abstract

BACKGROUNDEvidence-based clinical care guidelines effectively assists medical teams to increase the quality of clinical practice, and improve outcomes in patients. This study aimed to design and implement evidence-based care guidelines for removing arterial sheath in patients undergoing angioplasty of coronary artery.METHODSThis clinical trial study was performed on 200 patients (two groups of 100 patients) with mean age of 62.5 ± 10.8 years, from July 2014 to February 2014 in Baqiyatallah University of Medical Sciences (BUMS), Tehran, Iran. First, we designed a five-step guideline for removing arterial sheath. Then, the designed guideline (based on five-step Stetler model, i.e. preparation, validation, comparative study, implementation, and execution) in the current study, and the routine guideline were used for removing arterial sheath in patients in the intervention and the control groups, respectively. In both groups, the relevant outcomes including bleeding, vasovagal reactions, urinary retention, and pain were evaluated.RESULTSThere were significant differences between the two groups in terms of bleeding, hematoma, vasovagal reactions (n = 11 versus n = 24), urinary retention (n = 8 versus n = 31), and back pain after removing arterial sheath (P < 0.050 for all).CONCLUSIONBased on the results of this study, the use of evidence-based care guidelines after removal of atrial sheath in patients undergoing angioplasty is recommended.