VASCULAR ACCESS SITE BRUISING

Abstract

<p>Introduction</p> <p>The most common complication following invasive cardiac procedures is the development of vascular access site (VAS) bruising. The extent and impact of VAS bruising is poorly understood and minimally reported in the literature. Research into this common post-procedure complication is hindered by the lack of a reliable bruise measurement tool, and the concept that VAS bruising is a minor complication. This mixed methods study examined the inter-rater reliability of two methods to measure VAS bruise size. The embedded qualitative descriptive study explored patient perceptions of VAS bruising.</p> <p>Methods</p> <p>Participants having femoral or radial artery puncture for invasive cardiac procedures were included in this study. Participants reporting VAS bruising completed self measurement of bruise size using two methods, linear measurement and planimetry. The principal investigator and research assistant completed bruise measurements at the same time, and were blinded to participant and each others’ measurements. Following bruise measurement, the principal investigator conducted semi-structured interviews on a convenience sample of participants; including both sexes, a range of ages, and bruise sizes.</p> <p>Results</p> <p>Measurements were completed on 40 participants with VAS bruises. Analysis of inter-rater reliability was done using the intraclass correlation coefficient (ICC), two-way random effects model. The inter-rater reliability for both linear measurement and planimetry between all three measurers was high (.929; .914 respectively). Analysis of participant narratives uncovered three major themes concerns, impact and mediating factors, with several sub-themes.</p> <p>The findings of this study support the reliability of patient VAS bruise measurement using linear measurement and planimetry. The goals and available resources for VAS research may determine the choice of measurement approach. Qualitative descriptive results indicate that patients have concerns related to VAS bruising and that this bruising may impact activities of daily living. Future research examining VAS complications should include evaluation of VAS bruising as significant patient outcome.</p>