Ask an answerable question (PICO)：
Cardiac catheterization is an important clinical examination used to diagnose cardiovascular problems. The purpose is to evaluate heart and valve function, vascular obstruction, etc. to differentially diagnose heart diseases. Sometimes it can be directly treated during the examination process. It can be performed by puncturing the femoral artery in the thigh or surrounding arteries in the wrist. In order to prevent the occurrence of bleeding, hematoma, and other complications at the puncture site, patients who undergo femoral artery puncture must lie on bed for 6 h. Bed rest for a long period of time is often accompanied by back pain and difficulty in urination. Additionally, the patient being noncompliant with lying down for 6 h and frequently asking whether the bed rest duration can be reduced and early ambulation can be carried out are some problems often faced by nurses. Therefore, an empirical method was used to investigate whether routine bed rest for 6 h and early ambulation for 2-4 h will lead to complications after transfemoral cardiac catheterization.
The Method and Analysis of Literature Review：
The article is demonstraged in EBM, setting “cardiac catheters”, “femoral artery”, “early ambulation”, “late ambulation, “ hemorrhage”, “hematoma”, “complications” as keywords in PICO；Under brin logics, the keywords were included in the Union of 「OR」and the Intersection of 「AND」, and using cut-off words for searching. Searching in databases such as Cochrane library, Embase, PubMed、CINAHL, Taiwan journal article index system and Huayi on line library while adjusting the sezrching settings, 31 related documents were included. After excluding duplication un-related titles, abstracts, and interventions, two systematic review and meta-analysis studies that met the subject were reviewed.
Critical Appraisal：
According to the clinical research evidence level of “ Oxford Centre for Evidence- Based Medicine 2011 Levels of Evidence”, the Critical Appraisal Skills Programme (CASP) (2018) was used as a reviewing tool to pull out article reviews on three aspects: validity, omportance, and practicability. The reviewed articles are all rated as Level 1.
Results, Conclusions and Recommendations：
The results of analyzing two papers showed that the reduction of bed rest duration to 2-4 h for patients who have undergone transfemoral cardiac catheterization does not increase the risk of hematoma and bleeding at the puncture site. Allowing early ambulation can effectively decrease back pain, alleviate urination difficulties, and increase treatment satisfaction, and this study can be used as a clinical reference.
