Effects of Evidence-Based Nursing Care for Promoting Peripheral Tissue Perfusion among Critically Ill Patients with Peripheral Artery Disease A Single-Blinded Randomized Controlled Trial
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Abstract
Purpose: To study the effects of evidence-based nursing care for promoting peripheral tissue perfusion among critically ill patients with peripheral artery disease.
Design: A single-blinded randomized controlled trial research.
Methods: The participants were critically ill patients with peripheral artery disease after revascularization and were conducted in a surgical intensive care unit. The 30 participants were recruited via purposive sampling with inclusion and exclusion criteria and randomly assigned to the experimental and control groups with 15 each using sequentially numbered, opaque, sealed envelopes. Evidence-based nursing care for promoting peripheral tissue perfusion among critically ill patients with peripheral artery disease was used as the study intervention. Data collection was implemented through case record form, ankle–brachial index measurement, and signs of 6Ps assessment form. Data were analyzed using the chi-square, Fisher’s exact test, Mann-Whitney U test and independent t–test.
Main finding: After receiving the intervention, the mean ankle-brachial index level of the experimental group ( = 0.98, SD = 0.22) was higher than that of the control group (
= 0.76, SD = 0.18) at significance level .05 (p = .006). The incidences of signs of 6Ps, including pain and poikilothermia of the experimental group were significantly different from the control group (p < .05). However, the incidences of signs of 6P including pallor, paraesthesia, paralysis, and pulselessness in both study groups were not significantly different.
Conclusion and recommendations: This evidence-based nursing care is an effective method for promoting peripheral tissue perfusion and decreasing acute limb ischemic signs and symptoms among critically ill patients with peripheral artery disease. Thus, this evidence-based nursing care should be promoted to apply in care for another similar patients.
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References
Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation. 2017;135(12):726–79. doi: 10.1161/CIR.0000000000000502.
Centers for Disease Control and Prevention. About peripheral arterial disease (PAD) [Internet]. Atlanta, GA: CDC; 2022 [cited 2022 Aug 1]. Available from: https://www.cdc.gov/heart-disease/about/peripheral-arterial-disease.html?CDC_AAref_Val=.
Song P, Fang Z, Wang H, Cai Y, Rahimi K, Zhu Y, et al. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study. Lancet Glob Health. 2020;8:e721-9. doi: 10.1016/S2214-109X(20)30117-0.
Arworn S, Kosachunhanun N, Sony K, Inpankaew N, Sritara P, Phrommintikul A, et al. Underrecognition and undertreatment for peripheral arterial disease in diabetic patients in Thailand. J Med Assoc Thai. 2017;100(2):149-57.
Senanarong V, Harnphadungkit K. Peripheral vascular disease is associated with cognition, activities of daily living, and gait performance. Thai Journal of Neurology. 2019;35(4):18-23. (in Thai).
Sopittapan B, Kanogsunthornrat N, Siripitayakunkit A. Knowledge and self-care practice in patients with peripheral arterial occlusive disease. Thai Journal of Cardio-thoracic Nursing. 2018;29(2):43–54. (in Thai).
Morais SCRV, Nóbrega MMLD, Carvalho EC. Cross-mapping of results and nursing interventions: contribution to the practice. Rev Bras Enferm. 2018;71(4):83–90. doi: 10.1590/0034-7167-2017-0324.
Sonpee C, Chaiviboontham S, Pootracool P. Development and evaluation of clinical practice guideline for patients with critical limb ischemia undergoing revascularization. Thai Journal of Nursing and Midwifery Practice. 2022;9(2):23–42. (in Thai).
Bevan GH, White Solaru KT. Evidence-based medical management of peripheral artery disease. Arterioscler Thromb Vasc Biol. 2020;40(3):41–53. doi: 10.1161/ATVBAHA.119.312142.
Zahner GJ, Cortez A, Duralde E, Ramirez JL, Wang S, Hiramoto J, et al. Association of comorbid depression with patient outcomes in critical limb ischemia. Vasc Med. 2020;25(1):25–32. doi: 10.1177/1358863X198802.
Kohn CG, Alberts MJ, Peacock WF, Bunz TJ, Coleman CI. Cost and inpatient burden of peripheral artery disease: findings from the national inpatient sample. Atherosclerosis. 2019;286:142-6. doi: 10.1016/j.atherosclerosis.2019.05.026.
Natarajan B, Patel P, Mukherjee A. Acute lower limb ischemia-etiology, pathology, and management. Int J Angiol. 2020;29(3):168–74. doi: 10.1055/s-0040-1713769.
Rungkhachonsak S, Sumnuan T, Vutisirinukool S, Dechpong S. Prognostic factors of major amputations in patients with acute limb ischemia. Health Science Clinical Research. 2022;37(1):22–32. (in Thai).
Abramson BL, AL-Omram M, Anand SS, Albalawi Z, Coutinho T, de Mestral C, et al. Canadian cardiovascular society 2022 guidelines for peripheral arterial disease. Can J Cardiol. 2022;38(5):560–87. doi: 10.1016/j.cjca.2022.02.029.
Björck M, Earnshaw JJ, Acosta S, Bastos Gonçalves F, Cochennec F, Debus ES, et al. Editor’s choice –European society for vascular surgery 2020 clinical practice guidelines on the management of acute limb ischaemia. Eur J Vasc Endovasc Surg. 2020;59(2):173–218. doi: 10.1016/j.ejvs.2019.09.006.
Khammathit A. The evidence-based approach in health care management, applied to nursing. The Southern College Network Journal of Nursing and Public Health. 2021;8(2):315–28. (in Thai).
McIntosh SE, Freer L, Grissom CK, Auerbach PS, Rodway GW, Cochran A, et al. Wilderness medical society clinical practice guidelines for the prevention and treatment of frostbite: 2019 update. Wilderness Environ Med. 2019;30(4):19–32. doi: 10.1016/j.wem.2019.05.002.
Kawasaki T, Uemura T, Matsuo K, Masumoto K, Harada Y, Chuman T, et al. The effect of different positions on lower limbs skin perfusion pressure. Indian J Plast Surg. 2013;46(3):508–12. doi: 10.4103/0970-0358.121995.
Radhika J, Poomalai G, Nalini S, Revathi R. Effectiveness of Buerger Allen exercise on lower extremity perfusion and peripheral neuropathy symptoms among patients with diabetes mellitus. Iran J Nurs Midwifery Res. 2020;25(4):291-5. doi: 10.4103/ijnmr.IJNMR_63_19.
Srivastava J, John RP, Reddy H. Effectiveness of Buerger Allen’s exercise on foot perfusion among type 2 diabetes mellitus patients. Ann Rom Soc Cell Biol. 2022;26(1):2721-32.
Taebtam S, Wonggom P. The development and feasibility study of evidence-based nursing care for promoting peripheral tissue perfusion among critically patients with peripheral artery disease. Journal of Nursing Science and Health. 2024;47(3):68-81. (in Thai).
Soukup SM. The center for advanced nursing practice evidence-based practice model: promoting the scholarship of practice. Nurs Clin North Am. 2000;35(2):301-9.
Wolters Kluwer Health. JBI EBP database guide [Internet]. Philadelphia, PA: Wolters Kluwer Health; 2022 [cited 2022 Aug 1]. Available from: https://ospguides.ovid.com/OSPguides/jbidb.htm.
Sathya K, Karthi R. A study to assess the effectiveness of Buerger Allen exercise to prevent risk of diabetic foot by improving lower extremity perfusion among clients with type-2 diabetes mellitus in selected hospitals at Villupuram District, Tamilnadu. International Journal of Research and Review. 2019;6(3):83-8.
Cohen L, Manion L, Morrison K. Research methods in education. 6th ed. London: Routledge; 2007. 656 p.
Kulezic A, Macek M, Acosta S. Inadequacies of physical examination in patients with acute lower limb ischemia are associated with dreadful consequences. Ann Vasc Surg J. 2022;82(1):190–6. doi: 10.1016/j.avsg.2021.10.067.
Sagris M, Katsaros I, Giannopoulos S, Rosenberg RD, Altin SE, Rallidis L, et al. Statins and statin intensity in peripheral artery disease. Vasa. 2022;51(4):198–211. doi: 10.1024/0301-1526/a001012.