EFFECTS OF MODIFIED POSITIONING AND MOBILIZATION ON BACK PAIN AND DELAYED BLEEDING IN PATIENTS WHO HAD RECEIVED HEPARIN AND UNDERGONE ANGIOGRAPHY - A PILOT-STUDY

OBJECTIVE: To examine the effects that a modified positioning and mobi lization routine had on back pain and delayed bleeding in patients who had received heparin and undergone cardiac angiography. DESIGN: An ex perimental research design was used. Each patient was assigned randoml y to either the control group, which required 6 hours of bed rest afte r cardiac angiography, or the experimental group. The experimental gro up had modified positioning, in which the head of the bed was elevated to a maximum of 45 degrees, arid modified mobilization, in which they were ambulated briefly at the bedside 4 hours after angiography. SETT ING: Two cardiology units of a 700-bed urban teaching hospital in west ern Canada. SAMPLE: All patients admitted for nonemergent cardiac angi ography were approached for consent, to attain a sample of 29 patients , and were randomly assigned to the experimental or the control group. METHOD: Each patient was randomly assigned before cardiac angiography . The assignment was confi dential until the patient was admitted to t he cardiac unit after angiography. A demographic tool and the McGill P resent Pain Intensity Scale were used to collect data. Perception of p ain was evaluated over four observation periods. A research assistant monitored sanguineous drainage on the dressing and hematoma to evaluat e the presence of delayed bleeding. DATA ANALYSIS: Demographic informa tion was analyzed primarily through descriptive statistics. Results we re analyzed to compare back pain and delayed bleeding between the two groups. Wilcoxon scores and t tests both were used for analysis and co rrelated well with each other. RESULTS: The group with the modified po sitioning and mobilization routine experienced significantly less pain overall (p = 0.02), less pain at each interval, and significantly les s pain intensity (p < 0.05). There Was no difference in bleeding. One person in each group had an estimated blood loss of more than 100 ml t hrough. the pressure dressing. CONCLUSION: This pilot study supports o ur hypothesis that modifying the immobilization of patients after card iac angiography is associated with a reduction in back pain and with n o increase of delayed bleeding at the femoral access site. The results support the need for further investigation of ambulation intervention s after cardiac angiography.