Question

You are a Nurse Manager on a medical-surgical unit. Recently, you have noticed there have been many intravenous infiltrations of multiple types of medications, with poor outcomes. Your job is to gather the evidence to determine what the literature is recommending for educating your nurses on the unit about intravenous infiltrations and extravasations. Because you are a professional nurse and are learning to become an evidence-based manager, you use the evidence-based approach to the problem. Based on the readings:

1. What six questions would you ask to gather data? Explain where you would go to gather the data and why.
2. Where would you get your sources from?
3. Name and explain at least four misconceptions about evidence-based practice.

Answer 1

Infiltration is the leakage of fluid or medications from insertion site to the surrounding tissue. It may be caused by improper placement or dislodgement of iv catheter.

Extravasations occurs when vesicant medications leak out of the vein into tge tissue around it.

In many instances patients have several unsuccessfull attempts before a successfull iv line. Current protocol is an iv line should keep only 72 hours even it is good from dwell time. Valid assessment of iv sites is depend upon the use if valid reliable phlebitis scale.

*METHODS USED TO OBTAIN AND REVIEWEVIDENCE BASED PRACTICE

Medline and CINAHL

Schultz guidelines

An evidence based practice team was formed on the unit, to monitor iv sites for 1 month.

#most of iv's that did not have start date labels.

#it is imposdible to determine the need of changing catheter or iv cannula.

@colour

@odour

Many of themedications are damaging vein. Evidence based practice is a patient centered approach which determines the quality of care.

MAIN BENEFITS OF EVIDENCE BASED PRACTICE

*Increased patient outcomes

*lower cost of care

*superior nursing skills

It is an integral component of delivering high quality care.

QUESTIONS TO GATHER DATA

@Accuracy of labelling catheter.

@Important consideration for the patients while receiving iv therapy.

@sterile techniques followed before procedure.

@medications used and its prescribed order.

@size of iv cannula used for different patients.

#Data should be collected from different patient settings.

MISCONCEPTIONS OF EVIDENCE BASED PRACTICE

*Ignore expert advice.

*Evidence can prove the truth about things.

*valid and relevant evidence.

*if you don't have the evidence you can't practically do anything.