Selecting to publish my manuscript with the American Journal of Nursing best fit my project on rotating peripheral IV’s when only clinically indicated. The American Journal of Nursing target multidisciplinary in healthcare. It is the most used journal for healthcare professionals and covers clinical evidence-based practices. My project proposal would be of interest to healthcare professionals of all nursing specialties because it will improve patient quality care and nursing workflow.
Infusion Nurse Society (INS) guidelines recommend peripheral lines to be rotated every 72-96 hours to reduce complication such as phlebitis, infiltrations, and pain. However, my facility has found that rotating peripheral IV’s without complication has caused an
increase in cost, multiple sticks for patients, and increase the workload for the vascular access team (VAT). Patients with difficult access have a delay in care which results in death. Gorski et al. (2012) indicated nerve damage, infiltrations and extravasation can occur during insertion of peripheral line. Patient has an increase in stress related to having multiple attempts for peripheral lines. According to Bolton (2015), the article suggests an increased in manipulation associated with skin integrity being breached can increase infection in patients. Patients with difficult access have increased the use of central venous access which has increased the infection of the facility. Searching various research articles evidence as shown no clear evidence supports rotating peripheral IV’s 72-96 hours prevent complications. Evidence suggest rotating peripheral lines only when clinically indicated, and organization should change policy and procedures. The benefits to changing the policy from rotating peripheral lines every 72-96 hours to clinically indicate save a patient from unnecessary IV sticks and stress. This change is feasible to the organization reduction in cost, quality patient care, and VAT workload. This project will reflect changes need within the nursing practice guidelines and the policy and procedures. Publishing my manuscript in the American Journal of Nursing can educate nurses on nursing practice guidelines changes and the impact this change would have on patient care.
I also plan on taking a course after graduating from the nursing program specific to IV therapy because I feel this is a skill that takes practice and not having the hands-on experience through the nursing program at Niagara College is unfortunate. The IV therapy course is offered at Niagara College for a six-week period. I feel by taking this course I will become more comfortable with IV’s and will meet the expectations of the CNO when providing care to patients as a future nurse. I will also use the CNO standards of medication when administering an IV solution because it is a medication and the 10 rights need to be applied (CNO,
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
Intravenous therapy (IV therapy) is a method used to help the patient get better. Intravenous lines are put in for things as simple as delivering fluids when the patient is dehydrated to administering emergency lifesaving pharmaceuticals. As a patient or health care provider negative outcomes, such as having unneeded complications and jeopardizing patient comfort from an intravenous line is the last thing needed.
Nurses assess patients’ perineal swelling, lacerations, and monitor signs of infection. In conjunction, nurses also assess patient’s pain levels from perineal trauma and can provide pharmacologic and non-pharmacologic pain relief (Steen et al., 2007). Based on the centrality of their role, it is important that nurses have access to evidence based best practices on perineal pain management. Yet, nursing does not exist in a vacuum and there are many factors that may influence the translation of research evidence into a clinical setting. As stated by the Canadian Nursing Association, “Decision-making in nursing practice is influenced by evidence and also by individual values, client choice, theories, clinical judgment, ethics, legislation, regulation, health-care resources and practice environments” (CAN, 2010, p. 3). With this at the forefront, I will explore some of the organizational challenges to implementing Steen et al.,(2007) findings, such as, cost effectiveness, practice environment, standardization and time constraints. I will then explore the application of the evidence to my clinical example by addressing how Steen et al., (2007) evidence might have changed the care I provided to my
Peripheral artery disease is usually caused by atherosclerosis, which is when fatty deposits accumulate in the arteries of, most likely, limbs. This does affect all arteries throughout the body, then in turn, slowing the blood flow. PAD may also be due to inflammation of the blood vessels, injury to the extremities, or even exposure to radiation. “Peripheral arterial disease (PAD) affects approximately 10% of the American population” (Gurbir Dhaliwal; Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment; 2007). If not taken care of, PAD may lead to critical limb ischemia, open sores on the feet or legs that become infected by gangrene. The gangrene is then removed surgically, but doctors might have to amputate the extremity all together. Another issue that arises with PAD if it is not under control is the risk of stroke or heart attack. These can cause death to part of the heart or brain, or even death itself. The population more at risk would be smokers, diabetics, people who are obese, those with hypertension or hyperlipidemia, over the age of 50, have a family history of PAD, or those with a high level of homocysteine. If someone does fall into a few of these categories a physician can do a few tests to check for PAD. The doctor will more than likely start off with a physical exam, blood test, and possibly an ultrasound. From there the physician may try an ankle-brachial index, or ABI, which compares the blood pressure of the feet to the blood pressure of the arm. “An American survey of 2174 patients older than 40 years of age used the ankle-brachial index (ABI) as a screening tool, and showed a PAD prevalence of 0.9% between the ages of 40 and 49 years, 2.5% between the ages of 50 and 59 years, ...
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
Potter, P.A. & Perry, A.G. (2009). Fundamentals of Nursing (7th ed.). St. Louis, Mo.: Mosby Elsevier.
Hinkle, Janice L, Cheever, Kerry H. (2014). Brunner &Suddarth’s textbook of Medical-Surgical Nursing. Philadelphia: Wolters Kuwer/Lippincott Williams &Wilkins.
...anging as new research and methods are discovered to better serve the patients and healthcare professionals (Ignatavicius & Workman, 2013). As nurses use rounding in all their patient care, they will become more skilled with the nursing process, especially with assessments and interventions. Patients are the major users of hospitals and deserve the highest level of care with the best outcomes. With nurse rounding, patient outcomes are improving with a reduction in patient falls and pressure ulcers, use of call light, patient complaints, and most importantly an increase in patient satisfaction (Forde-Johnston, 2014). Nurses play a critical role in the patient care experience; they have the ability to transform healthcare by delivering optimal care thereby improving quality and safety through competent and compassionate use of nurse rounding (Blakley, et al.,2011).
The human body is the most complex organism in the world. A vast majority of society never gives it real thought, but our body is a well oiled machine composed of several systems with separate functions yet they all work together. No man can recreate an exact working replica of a human; even with all of our technology we still do not fully understand it. Each day anatomists and physiologists are getting closer, by making medical breakthroughs. Therefore, since the study of the human body constantly is evolving, so is the study of medicine. These changes pertain to every position held in the medical field, including nurses. As doctors’ duty is to become well informed of the constant changes, it is just as important for nursing staff to evolve as well. Most people do not realize the very valuable role a nurse plays in the process of treating a patient. Actually, some would say that nurses are more valuable than the doctors’. It is the nurse that gives the direct patient care by working with patients to monitor, evaluate, and implement their best judgment regarding the patients care. This is a very large responsibility for any person, let alone someone who has not attended medical school. Granted, nurses generally operate within certain perimeters set by the doctors’ orders, but there are times where nurses have to implement their own skills. A good nurse must be a good communicator, must be well educated and willing to evolve with the industry, and most importantly must be able to implement last minute critical thinking skills.
Potter, P.A., Perry, A.G., Stocker, P.A., & Hall. (2017). Fundamentals of Nursing (9th ed.). St. Louis, MO:
Several skills are beneficial to the nurse and paramedic, but perhaps one of the most important skills is the ability to place an intravenous catheter into a vein. This procedure is most commonly referred to as “starting an IV”. In today’s medical community, intravenous cannulation is necessary for the administration of many antibiotics and other therapeutic drugs. Listed below are the procedures and guidelines for starting a successful IV. Following these instructions will provide a positive experience for the patient and clinician.
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
After almost one hour of “tube procedure connections”, I got up to go to the restroom with an IV pole following my s...