Effects of Position Change After PCI
Condition: Percutaneous Coronary Intervention; Coronary Artery Disease
MeSH terms: Coronary Artery Disease
Study type: Interventional

Summary: 
      Aims and objectives: To determine the effect of position change that is applied after
      percutaneous coronary intervention on vital signs, back pain, and vascular complications.

      Background: In order to minimize the post-procedure complications, patients are restricted to
      prolonged bed rest that is always accompanied by back pain and and hemodynamic instability.

      Design: Randomized-controlled quasi experimental study Methods: The study sample chosen for
      this study included 200 patients who visited a hospital in Turkey between July 2014 and
      November 2014. Patients were divided into two groups by randomization. Patients in the
      control group (CG, n = 100) were put in a supine position, in which the head of the bed (HOB)
      was elevated to 15°, the patient's leg on the side of the intervention was kept straight and
      immobile; positional change was applied to patients in the experimental group (EG, n = 100).
    

Detailed description: 
      Percutaneous coronary intervention (PCI) is an interventional procedure used to diagnose and
      treat chronic coronary artery disease. The recommended period of bed rest following a PCI is
      reported by Rolley et al. (2011) as being 2-4 hours (h). According to evidence-based
      guidelines in relevant literature, however, the bed rest was reported from 2-24 h; in these
      instances the supine position (SP) was used, which leads to movement limitation.

      Among the patient-care goals during the post-procedural period, sustaining tissue perfusion
      and heart and vascular system operation, regulating vital signs, reducing pain, and
      supporting movement are important. According to such a procedure, the nurse's independent
      role is to provide the safest position for the patient, thereby positively affecting vital
      signs after PCI and reducing vascular complications and back pain.

      Recently, similar nursing studies have reported the effect of position change after PCI on
      back pain, as well as vascular complications after PCI, the effect of position change on
      certain vital signs and vascular complications, the effect of position change regarding pain,
      patient comfort and certain vital signs, and the effect of positional change on intervention
      pain and all vital signs. Some studies have also looked into the effect of positional changes
      on back pain, certain vital signs, and vascular complication.

      Prolonged bed rest in a SP has become tradition, but it can have negative effects.
      Comprehensive studies in the existing literature that can be applied to the post-PCI nursing
      care process-and which study the effect of the most reliable positional change on all vital
      signs, vascular complications, and, back pain-display a numerical inadequacy. Consequently,
      the authors intend the current study to be an experimental investigation of the effect of
      position change on vital signs, vascular complications, and back pain.
    

Intervention name(s): position change applied at different times
Intervention type(s): Other
Intervention description(s): Time 1 - in the first fifth minute after the procedure supine position in which the HOB was elevated 15° Time 2 - in the first hour low fowler's position were given in which the HOB was elevated 15-30° Time 3 - in the third hour semi high fowler's position were given in which the HOB was elevated 30-45° Time 4 - in the fourth hour left or right lateral position were given in which the HOB was elevated 15° Time 5 - in the fifth hour low fowler's position were given in which the HOB was elevated 15-30° Time 6 - in the sixth hour standard fowler's position were given in which the HOB was elevated 45-60°
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized-controlled quasi experimental study
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Back pain; patient positioning; vascular complications; vital signs