Effect of Implementing Nursing Guidelines on Improving Local Vascular Outcomes among Patients Undergoing Primary Percutaneous Coronary Intervention
DOI:
https://doi.org/10.31674/mjn.2025.v17i01.022Abstract
Background: Complications associated with cardiac catheterisation, such as vascular complications, which include haematoma and ecchymosis, are the most frequent and can worsen patient outcomes while exposing patients to longer hospital stays and increased hospital expenses. Nurses can predict complications and reduce the possibility of their occurrence. Objectives: To evaluate the effect of implementing nursing guidelines on improving local vascular outcomes among patients undergoing primary percutaneous coronary intervention. Methods: The study was carried out at a coronary care unit at Heart Hospital of Assiut University, Egypt, using a quasi-experimental research design. A purposive sampling of 150 patients was used. Three tools were utilised to collect data - patient assessment tool, predictive Vascular Complications Risk (VASCOR) score assessment and patients' outcomes tool. Results: The outcomes revealed that study populations were at high risk (78.7% and 73.3%) for developing vascular complications. The difference between study populations was statistically significant for haematoma (p=0.014), insertion site pain (p=0.001) and bleeding (p=0.016) after application of a cold compress. Regarding discharge criteria, the difference between study populations was statistically significant (P value 0.005). Length of stay at CCU was statistically significant (P value 0.001), shorter in the intervention group. Conclusion: The study confirmed that patients' outcomes can improve through early prediction of complications, and nursing guidelines were effective in improving patients' outcomes.
Keywords:
Primary Percutaneous Coronary Intervention, Nursing Guidelines, Vascular OutcomesDownloads
References
Al-Bayati, H. M., & Al-Kassar, R. A. H. (2023). Effect of direct cold compress for femoral arterial sheath removal on reduction of local vascular complications in patients after percutaneous coronary intervention: A randomized controlled trial. Kufa Journal for Nursing Sciences, 13(2), 99-110. https://doi.org/10.36321/kjns.vi20232.12477
Asy’ary, Q., Wihastuti, T. A., & Ismail, D. D. S. L. (2024). Comparison of sand pillows and cold compresses in reducing the incidence of haematoma in post Percutaneous Coronary Intervention (PCI) Patients: A Scoping Review. Jurnal Health Sains, 5(5), 299-306. https://doi.org/10.46799/jhs.v5i5.1266
Cheema, A. A., Abbas, S., Shahid, M., Ahmed, M. S., Usmani, S., & Ali, S. M. N. (2024). The Impact of Radial Vs Femoral Access on Vascular Complications and Patients Outcomes in Complex PCI. Journal of Health and Rehabilitation Research, 4(2), 466-470. https://doi.org/10.61919/jhrr.v4i2.876
Chiarito, M., Cao, D., Nicolas, J., Roumeliotis, A., Power, D., Chandiramani, R., Sartori, S., Camaj, A., Goel, R., & Claessen, B. E. (2021). Radial versus femoral access for coronary interventions: an updated systematic review and meta‐analysis of randomized trials. Catheterization and Cardiovascular Interventions, 97(7), 1387-1396. https://doi.org/10.1002/ccd.29486
Galli da Silveira, C., Ferraz de Almeida, G. M., Garcia de Avila, M. A., Fernandes Teixeira, T. R., & Alves Lima, F. M. (2024). Immediate complications of femoral vascular sheath removal: a cross-sectional study. Anna Nery School Journal of Nursing/Escola Anna Nery Revista de Enfermagem, 28. https://doi.org/10.1590/2177-9465-EAN-2024-0057en
Gupta, A., Choudhary, S., Pathak, V., & Pathak, P. (2021). Incidence and Predictors of Post-catheterisation Femoral Artery Access Vascular Complication in North Indian Population. Journal of Clinical & Diagnostic Research, 15(6). https://doi.org/10.7860/JCDR/2021/48572.15041
Hamdi, S. M., Abd El Megeed, E. S., Abd Al Ghaffare, M., & Abdelmowla, R. A. A. (2023). Incidence and Risk Factors of Haematoma Formation at Femoral Access Site among Patients post Cardiac Catheterization. Assiut Scientific Nursing Journal, 11(39), 58-68. https://doi.org/10.21608/ASNJ.2023.226969.1652
Hussein, A., Dawood, S., & Mohammed, A. (2022). Nurses' Knowledge and Practice toward Post Cardiac Catheterization Patients' Safety. BNIHS Journal. 140(1), 919-924. https://www.healthsciencesbulletin.com/volume/BNIHS/140/01/nurses-knowledge-and-practice-toward-post-cardiac-catheterization-patients-safety-62568117e6a8e.pdf. Accessed on 16th June, 2023.
Ibrahem Shalaby, Y. M., Abdelwahab Abdelfatah, D. A., Omran, A. I., & Abdelkader Habiba, A. I. (2024). Clinical Outcomes and Satisfaction Level among Patients Undergoing Diagnostic Cardiac Catheterization. Egyptian Journal of Nursing and Health Sciences, 5(1), 102-118. https://doi.org/10.21608/EJNHS.2024.347649
Iqbal, N., Butt, Z. M., Dasti, M. A., Memon, F. F., Khan, A. A., & Rizvi, S. N. H. (2023). Outcomes of Primary Percutaneous Coronary Intervention in Patients with a Thrombolysis in Myocardial Infarction Score of Five or Higher. Pakistan Journal of Medical & Health Sciences, 17(04), 554-554. https://doi.org/10.53350/pjmhs2023174554
Khan, F. U., Khan, T. I., Khan, M. I., Musa, M., & Rashid, F. (2025). Predictors of Radial Artery Haematoma and Outcomes in Patients Undergoing Elective vs Emergency Angiography Angioplasty via Radial Artery Approach. Indus Journal of Bioscience Research, 3(2), 484-490. https://doi.org/10.70749/ijbr.v3i2.736
Koifman, E., Gaglia Jr, M. A., Escarcega, R. O., Bernardo, N. L., Lager, R. A., Gallino, R. A., Ben‐Dor, I., Pichard, A. D., Baker, N. C., & Lipinski, M. J. (2017). Comparison of transradial and transfemoral access in patients undergoing percutaneous coronary intervention for complex coronary lesions. Catheterization and Cardiovascular Interventions, 89(4), 640-646. https://doi.org/10.1002/ccd.26669
Korkmaz, E., & Karagözoğlu, Ş. (2022). Comparison of sandbag, close pad, and cold application combined with sandbag in preventing peripheral vascular complications after cardiac catheterisation. Cumhuriyet Medical Journal, 44(2), 150-158. https://doi.org/10.7197/cmj.1053991
Kurt, Y., & Kaşıkçı, M. (2019). The effect of the application of cold on haematoma, ecchymosis, and pain at the catheter site in patients undergoing percutaneous coronary intervention. International Journal of Nursing Sciences, 6(4), 378-384. https://doi.org/10.1016/j.ijnss.2019.09.005
Manda, Y. R., & Baradhi, K. M. (2018). Cardiac catheterization risks and complications. Retrieved from: https://mdsearchlight.com/diagnostics/cardiac-catheterization-risks-and-complications-heart-catheterization/ Accessed on 12th June, 2023.
Paganin, A., Beghetto, M. G., Hirakata, V. N., Hilário, T. d. S., Matte, R., Sauer, J. M., & Rabelo-Silva, E. (2017). A Vascular Complications Risk (VASCOR) score for patients undergoing invasive cardiac procedures in the catheterization laboratory setting: A prospective cohort study. European Journal of Cardiovascular Nursing, 16(5), 409-417. https://doi.org/10.1177/1474515116684250
Pamuk, G. D., & Özkaraman, A. (2024). The Effect of Cold Sand Pack on Percutaneous Coronary Intervention-Induced Vascular Complications and Pain: A Randomized Controlled Trial. Florence Nightingale Journal of Nursing, 32(1). https://doi.org/10.5152/FNJN.2024.23074
Patil, H., Hesarur, V., & Mahanta, S. (2025). A Study to Assess the Effectiveness of Cryotherapy in Preventing Haematoma at the Arterial Puncture Site Among Post-percutaneous Coronary Intervention (PCI) Patients in a Selected Tertiary Care Hospital, Belagavi. Cureus, 17(3). https://doi.org/10.7759/cureus.80921
Romero, P. S., Costanzi, A. P., Hirakata, V. N., Beghetto, M. G., Sauer, J. M., & Rabelo-Silva, E. R. (2019). Subsample analysis of the Vascular Complications Risk Score at two public referral centers for interventional cardiology. Revista da Escola de Enfermagem da USP, 53. https://doi.org/10.1590/S1980-220X2018005103438
Sari, K. P. (2024). Assessing the Efficacy of Cardiac Catheterization in Enhancing Blood Circulation in Patients with Coronary Heart Disease: A Systematic Literature Review. Sriwijaya Journal of Internal Medicine, 2(1), 125-130. http://doi.org/10.59345/sjim.v2i1.102
Shahid, M., Chandra, V., Wajswol, E., Contractor, S., Shukla, P., & Kumar, A. (2020). Expedited TR Band Removal for Transradial Approach for Noncoronary Visceral Procedures: Initial Experience. Vascular and Endovascular Surgery, 54(3), 220-224. https://doi.org/10.1177/1538574419896744
Shakhgeldyan, K. I., Kuksin, N. S., Domzhalov, I. G., Rublev, V. Y., & Geltser, B. I. (2024). Interpretable machine learning for in-hospital mortality risk prediction in patients with ST-elevation myocardial infarction after percutaneous coronary interventions. Computers in Biology and Medicine, 170. https://doi.org/10.1016/j.compbiomed.2024.107953
Sokhanvar, S., Tirgari, B., Forouzi, M. A., Salari, M., & Jahani, Y. (2023). Effect of ice bag application to femoral region on pain and vital signs in patients with acute myocardial infarction undergoing percutaneous coronary intervention: a randomized controlled trial. The Open Nursing Journal, 17(1). https://doi.org/10.2174/18744346-v17-e230113-2022-133
Sugiharto, F., Yusanti, I., Sari, W. P., Yuliandani, E., Kosasih, C. E., Trisyani, Y., Priambodo, A. P., Nuraeni, A., Anna, A., & Emaliyawati, E. (2025). A Systematic Review of the Potential of Cold Compresses Therapy: Strategy for Preventing Haematoma and Alleviating Pain in Post Cardiac Catheterization Patients. Journal of Pain Research, 18, 161-175. https://doi.org/10.2147/JPR.S478280
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 The Malaysian Journal of Nursing (MJN)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
