Bed-rest post-femoral arterial sheath removal--what is safe practice? A clinical audit

Area of Science:

• Cardiology
• Vascular Surgery
• Healthcare Management

Background:

• Increased coronary angiography and angioplasty procedures in England necessitate optimized patient recovery protocols.
• Limited evidence exists on optimal bed rest duration post-femoral arterial sheath removal following cardiac procedures.
• Current practices may prolong hospital stays unnecessarily, impacting patient throughput.

Purpose of the Study:

• To determine optimal bed rest duration post-femoral arterial sheath removal.
• To evaluate if reducing bed rest time increases complication rates.
• To facilitate increased day case procedures by optimizing post-procedural care.

Main Methods:

• Literature review and clinical benchmarking to establish UK best practices.
• Audit tool development to collect data on haemostasis, bed rest duration, and complications.
• Comparative audit before and after reducing bed rest from 6 to 3 hours.

Main Results:

• Baseline audit: Median bed rest of 6 hours.
• Post-reduction audit: Median bed rest of 3 hours.
• No significant difference in femoral wound site complication rates observed after reducing bed rest.

Conclusions:

• Reducing bed rest duration to 3 hours post-femoral sheath removal is safe and effective for diagnostic and interventional procedures.
• This practice change reduces patient length of stay, enabling more day case procedures.
• Re-evaluation is recommended due to the increasing use of femoral arterial closure devices.