Date of Award

Spring 4-30-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Dr. Ruth Chavez

First Committee Member

Dr. Chai Sribanditmongkol

Second Committee Member

Dr. Joy Shoemaker


ACT, Activated Clotting Time, Rebleed, Pediatric, Cardiac Catheterization

Subject Categories

Medicine and Health Sciences


Cardiac catheterization (CC) procedure is a minimally invasive procedure that requires arterial and/or venous access with the introduction of a small tube called a sheath that allows for the passage of wires and catheters into the heart. Heparin is a medication known as a ‘blood thinner’ that is administered throughout the procedure to prevent clots from forming. The activated clotting time (ACT) is a diagnostic point of care test used to measure how long it takes blood to clot. Post CC care requires patients to lie flat for several hours to ensure bleeding will not occur at the punctured vessel site. Therefore, the ACT is a significant factor to consider before pulling sheaths at the end of a CC procedure to reduce the risk of post procedure bleeding. Currently no pediatric protocol exists for appropriate ACT level for sheath removal post CC in the pediatric population. The project team proposes a pilot project to collect data by performing a retrospective chart review on whether the peak ACT and ending post procedure ACT greater than 180 seconds affect rebleed rates post procedure at a large pediatric hospital located in Central Ohio. Rebleeding post CC procedure requires extra monitoring of the pediatric patient and places the patient at risk for agitation and a prolonged hospitalization. The scholarly project proposal concludes with a discussion of the barriers endured while trying to complete the project and provides recommendations to mitigate such challenges for future projects. Keywords: ACT, activated clotting time, rebleed, cardiac catheterization, pediatric

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, all rights reserved. Fair Use

CareyStaceyPosterN8000.pdf (989 kB)



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