The importance of nursing standards: Elements to create a standard for sheath decannulation according to EBP

Diagnostic coronarography and coronary interventions have become widely accepted procedures in patients with ischaemic heart disease, in the acute, chronic, as well as diagnostic stages. The interventions on coronary arteries are closely connected with diagnostic catheterization and deal with stenoses of coronary arteries. The diagnostic and interventional catheters used for the procedure are inserted through the femoral or radial artery. Decannulation of the sheath following the femoral and radial access is an important part of the procedure. This review article analyses the available literary sources, with the aim of determining the possibilities of standardization of the specialized nursing care provided for patients requiring decannulation of the sheath from the arteria radialis, or femoralis, following left-side coronary catheterization. The presented paper has been drawn up on the basis of a review of expert articles presented in freely accessible databases in the period between 2000 and 2012. The nursing standards for decannulation of the sheath obtained from the links to foreign literature often arise from the conclusions of nursing research (EBP). Standards concentrate on the means and length of compression of the arteria femoralis and arteria radialis; furthermore, they specify the compression device for the respective blood drainage area and maintaining the safety and comfort of the patient. Correctly set standards eliminate the rate of complications (haematoma, bleeding), in relation for example to the type of compression applied on the artery, or to nursing staff trained in compression techniques. The nursing standard is an important part of the procedure, contributing to a reduction in complications and an improvement in the patient's comfort, and has an important platform, especially abroad. Significant elements for the creation of standards and defining the correct criteria according to the EBP standard were analyzed from the available sources.