Every day, you make clinical decisions about many aspects of patient care, but you face challenges for many situations. Your first choice for a resource is the facility policy and procedure book, or to check other valued textbooks. Another option is to ask a trusted colleague. But what happens when your questions remain unanswered, or you wonder if practice can be made safer through use of more recent evidence. The Institute of Medicine established a goal of having 90% of clinical decisions based on the latest evidence but we are far from that goal.
When do you have the time to go to a computer, sign on to a search engine, locate the needed papers and analyze them? That is where we can help! Our Evidence-Based Practice Reports asks a clinical question, then provides a concise report based on the latest published evidence. We include term definitions, analysis of studies, recommendations for practice and the complete list of references used. We have just released a new EBP Report – Venipuncture and Lymphedema The Clinical Questions are
Numerous guidelines have statements instructing patients to avoid all punctures on the ipsilateral arm after breast cancer surgery. This recommendation based on a theory dates back to 1921. Almost 100 years later we still do not have a complete scientific answer. We did find 4 systematic literature reviews on these questions, but the studies are not high-level evidence and are conflicting. What happens when all veins in the unaffected arm cannot be found or your patient has had bilateral breast cancer? Learn more about the evidence for these decisions by obtaining this paper here. The first EBP Report is Continuous and Intermittent IV Sets The Clinical Questions are:
We welcome your ideas for new EBP Reports. Please email your suggestions. Finally, as a free service, we have compiled a paper on infusion therapy references. This list includes textbooks, journals, and standards and guidelines. Find a copy of Your Infusion Library here . And we are not finished with free services! All customers purchasing an online course, EBP report, recorded presentation, or other consulting services are invited to join a closed discussion group on Facebook – STIC or Stop the Infusion Confusion, an online, private community. The group discussions are facilitated by Lynn with her unique point of view as an experienced infusion therapy educator. Post questions and obtain continued support through interactive discussions. Watch for your invitation by email after your purchase.
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Intravenous (IV) therapy is increasing in skilled nursing facilities for several reasons. The number of IV medications is increasing and expanding to treat more diagnoses than ever before. The length of these IV medications may be a few doses, a few days, or the rest of the patient’s life. Medical diagnoses treated with a variety of IV fluids and medications include diabetes, heart failure, and many types of infections, which can be common among residents. Skilled nursing facilities (SNF) fill a great void when patients are not a candidate for home infusion services or when frequent travel to an ambulatory infusion clinic is not possible. Additionally, needs of current residents change and could easily include treatment with IV fluids and medications in your SNF. Value-based purchasing is being applied to skilled nursing facilities, after 10 years of experience in acute care hospitals. The focus for the SNF is on potentially preventable readmissions (SNFPPR) to an acute-care hospital. A quick look at the list of PPR conditions includes many that require treatment with intravenous infusions. Additionally, inadequate management of vascular access devices is well document to cause bloodstream infection and vein thrombosis. Central line associated bloodstream infection (CLABSI) has been regarded as a preventable hospital-acquired condition for the past 10 years. Its occurrence in a hospital means significant reduction in Medicare payments to the hospital. Is your nursing staff prepared to safely deliver IV fluids and medications? Can they safely insert a peripheral IV catheter and correctly administer the prescribed therapy while preventing serious complications like phlebitis, infiltration/extravasation, nerve injury, and infection? We can help with a different approach... We combine online delivery with a skills lab, reducing classroom time while providing a valuable learning experience. The online course material is based on the familiar nursing process – one chapter each on patient assessment, planning, intervention, and evaluation. The nurse chooses the time and place to access the course material online and has access to the material for a year. The goal is knowledge acquisition and critical thinking. After successful completion determined by passing an online exam, the skills lab offers a full day of practice in a structured simulation lab. Practice is guided by case studies and repetition is encouraged until the learner is comfortable. This is followed by a de-briefing session to discuss the specific skill and follow up on additional questions. The next Peripheral IV Therapy Skills day is March 28th. This offers a great way for developing IV therapy skills in your nursing staff. Register your nurses now to immediately begin the online class as its completion is required to attend the Skills Lab. Also atch for our next announcement about next blended learning offering - Central Venous Access Devices COMING SOON. |
Author: Lynn HadawayLynn Hadaway is an international thought leader in infusion therapy and vascular access, having been in this practice for more than 40 years. Her experience comes from hospital-based infusion teams, device manufacturers, and continuing education services. Her journal and textbook publications are extensive. She also maintains board certification in infusion nursing (CRNI) and nursing professional development (RN-BC). Categories
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May 2019
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