INTRODUCTION
Peripheral intravenous catheters show benefit in Cabooltures emergency departments every day, however emergency department has noticed PIC dislodging 48 hours after being inserted. The focus of this research trial is to compare the two types of patient group’s, standard group who used transparent cloth- bordered polyurethane dressing to PIC and skin group who transparent cloth boarded polyurethane dressing + cyanoacrylate glue to hold PIC, comparison was investigated. Patients selected for groups comprised of patients admitted to the emergency department with preexisting inserted PIC, aged 18 years plus. Primary issue concentrated on PIC failure at 48 hours in emergency departments and inferior outcomes included different IVC
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With the use of skin glue plus transparent cloth bordered polyurethane dressing will this help secure PIC’S in emergency departments compared to the standard group who used transparent cloth bordered polyurethane dressing alone?. What are other techniques used in other hospitals for securement of PIC’S. Will the use of cyanoacrylate glue as well as transparent cloth bordered polyurethane dressings help reduce the dislodgment rate of PIC’s in Caboolture emergency department patients? The study needed to find an ultimatum towards reducing failure rates with dislodgement that kept occurring in emergency departments, whilst using the PIC. Emergency departments in hospitals Caboolture in particular are spending too much money and time of the patient and medical team on the particular device the IPC. Patients are feeling vulnerable to reoccurring errors with dislodgment of PICS and nurses are other medical staff are feeling disappointed that they are unable to properly administer medication and other fluids properly within the IPC. The null hypothesis stated if addition of skin glue to the insertion site of peripheral intravenous catheters in the ED would reduce the device failure rate at 48 hours. Scientific hypothesis helps nurse researchers establish research trials and observe phenomenon being tested in these trials (Fabio Porto, 2015) Interventions …show more content…
Secondary outcome included types of different types of clinical failures that occurred with the ICP including infection of the area the catheter was placed which was upper limb IPC, phlebitis which included irritation and trauma to the vein the IPC was being placed into, occlusion which mentions the patient is unable to withdraw intravenous fluids from the IPC due to a blockage example thrombotic blockage., or dislodgement of IPC from patient this can be caused by loose fittings example transparent cloth bordered polyurethane
According to manufacturer-funded evidence, Tegaderm CHG is extremely effective at reducing the skin flora regrowth, or biofilm, that builds up underneath catheter dressings. Additionally, biofilm is a major source of CRBSI’s within the first week of build-up; biofilm is also a major source of tunnel exit site infections in long-term catheters. Again, according to manufacturer-funded studies Tegaderm has been proven extremely effective at reducing the biofilm build-up.
Association of Anaesthetists of Great Britain and Ireland (AAGBI). (2012). Checking anaesthetic equipment 2012. Retrieved from http://www.aagbi.org/sites/default/files/checking_anaesthetic_equipment_2012.pdf
Different studies had different result numbers or different percentage reduction rates which was primarily based on their indifferences in regards to study design utilized and sample size. As evidenced by research results (Magers, June 2013) and (Welden, 2013), these showed a reduction of urinary catheter days resulted in reduced CAUTI rates. Though different outcome results between the different research studies, they all strongly significantly supported the notion that a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter compared with a no protocol is essential to help in the reduction of CAUTIs. Interpreting these results, (Meddings et al., 2013) showed a drop greater than 52% in CAUTIs and a decrease in catheterization by 37%. The study results from the six scholarly research study articles showed nearly similar or corresponding outcomes. The results were significant enough to support the PICO question. In general, though the difference in sample size, the results still strongly supported excellent outcomes when a nurse-driven protocol is used to evaluate the necessity of continued urethral catheter use. (Chen et al., 2013, para.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
will require intravenous cannulation” (Ogston-Tuck, 2014). The key to prevention is knowing the cause of the problem. Some key nursing interventions as noted in the [Manual of IV Therapeutics] include using aseptic technique
Pressure ulcers remain a major health problem for patients in all health care setting but may gaps still remain in the understanding and prevention. Studies indicate that comprehensive prevention techniques such as repositioning and pressure relieving aids have slightly reduced incident rates but areas of high skin-bed interface pressures still remain in jeopardy. By preventing pressure ulcers, it would reduce health cost and patient comfort will be increased. Additional research is needed to determine the most appropriate preventative responses, thus, more research should be conducted in regards to the frequency of turning plus the use of pressure releasing equipment. (change and improve outcomes)
Retained foreign objects have been a major problem throughout operating rooms, labor and delivery, as well as any other procedural area that perform invasive procedures. Retained foreign objects include soft goods, such as sponges, needles, sharps, instruments and other small miscellaneous items used during a procedure (NoThing Left Behind, 2013). The retention of these items can lead to several complications such as a local tissue reactions, infection, obstruction of blood vessels, and even death (Mathias, 2013, p. 2) According to the OR Manager, the effects of a retained surgical item can lead to patients having a increased mortality rate by 2.14%, an increased hospital stay by 2.08 days, and increased hospital costs by $13,315 (Mathias, 2013, p.1). In response to this, NoThing Left Behind was created. NoThing Left Behind is a national surgical safety project that was created as a system wide policy to help prevent the event of a retained surgical item (RSI). This project estimates that there are 1500-2000 retained surgical items left in patients each year within the United States (NoThing Left Behind, 2013). Furthermore, evidence shows that there has been an increase in retained foreign objects left within patients that undergo invasive procedures that occur outside of the operating room and labor and delivery. Therefore, the focus of this paper is to analyze the negative impact, physically, emotionally, and financially, on patients as well as the hospital, related to retained foreign objects during an invasive procedure. The focus is on areas such as the catheterization lab, endoscopy, emergency room, and other bedside procedures where there is no accounting process in place.
In this section the researchers explain the complications that can occur based on non-adherence to a proper self-catheterization regimen. A spinal cord injury can cause an interruption in neural pathways which affect the function of the bladder causing urinary incontinence, urinary retention, urinary reflux, and recurrent urinary tract infections. These problems can ultimately lead to an increase in renal morbidity and mortality (Shaw & Logan, 2013) Later, in the discussion section of the article, the authors focus on the importance of nursing education to teach patients proper methods to perform and cope with ISC in order to eliminate these common occurrences in patients suffering from SCIs (Shaw & Logan, 2013). The perception of performing this task may vary from patient to patient. This research helps identify various educational approaches that could be taken to accommodate all patients. Therefore, the research is significant to nursing due to the fact that nurses are considered the primary educators and are expected to address practical issues with patients performing ISC and help them manage the psychological issues that are faced with this
I know this week you had a hard time finding a guideline that suited your PICOT question. Although you couldn’t find an article reviewing alcohol-impregnated caps understanding how to prevent intravascular infections definitely relates to your topic. In your summary I wish you have discussed some of the major recommendations. Other than that I believe you did a great job on this assignment. One item I thought was interesting was how the guideline discussed umbilical catheters. I honestly had never heard of this before, so it was a learning experience for me. “Umbilical venous catheters should be removed as soon as possible when no longer needed, but can be used up to 14 days if managed aseptically” (National Guideline Clearinghouse, 2011).
First, you must obtain all of the necessary supplies: gloves, alcohol or Betadine preps, a tourniquet, tape, an appropriately sized IV catheter, a bag of IV solution, the IV tubing, and gauze pads. While obtaining the supplies, you should inform the patient that IV catheter placement is necessary, and why. Do not lie to the patient and tell him or her that it is a painless procedure. Instead, be honest with them and explain that the initial puncture feels like a sharp pinch on the skin and that the pain and discomfort associated with the IV placement is only temporary. You may find it helpful to demonstrate to the patient the amount of pain to expect by pinching the skin on the back of their hand. This is especially helpful for younger patients or patients who are more concrete in their thinking.
Uncovering the Coated Truth Holly Baggett Tanya Kiatsuranon 5th Period Kirkpatrick January 5, 2015 Table of Contents Introduction Background Information and Research Purpose/Objective Hypothesis Parts of the Experiment Materials and Procedure Observations and Data Calculations Statistical Analysis Analysis Conclusion Sources of Error and Inaccuracies Application Improvement Bibliography Introduction
Polyethylene (PE) is one of the most commonly used polymers which can be identified into two plastic identification codes: 2 for high-density polyethylene (HDPE) and 4 for low density polyethylene (LDPE). Polyethylene is sometimes called polyethene or polythene and is produced by an addition polymerisation reaction. The chemical formula for polyethylene is –(CH2-CH2)n– for both HDPE and LDPE. The formation of the polyethylene chain is created with the monomer ethylene (CH2=CH2).
It has been proved with research that the needle stick injury always has been a big issue among student nurses and health care workers. There should be some more steps taken to avoid this serious
Frequently patients are not physically able to undergo more traditional treatments, their only option is to have a procedure done in IR, where minimally invasive techniques are used. Patients require education regarding the procedure and post procedure care. Many of our procedures involve placement of specialty lines, tubes and drains. According to Gastmans, throughout the nurse–patient relationship, the nurse and patient work together to become more knowledgeable in the care process (Gastmans, 1998). The importance of maintenance and care of the drain is stressed to the patient and family members.