![[ Visit Client Website ]](images/banner.gif)
Wednesday, 1 August 2012
Learning Objective 1: Identify evidence-based practice (EBP) implementation strategies and multiple methods for evaluating evidence-based changes that fit the institutional culture.
Learning Objective 2: Demonstrate the use of guidelines and translational strategies to implement an evidence-based intervention and potentially improve outcomes related to IV extravasations.
Intravenous (IV) extravasations, the inadvertent leaking of a vesicant agent out of the vein and into the surrounding tissue are a significant problem, particularly in pediatric populations. Consequences can range from short term inflammation to severe necrosis requiring reconstructive surgery. Standardized treatments for the management of IV extravasations are lacking. Hyaluronidase is an enzyme that can be used with many agents to disperse the extravasate into the tissue and minimize damage. An evidence-based guideline, Hyaluronidase for IV Extravasations, was developed using standardized methods and evaluated in a hospitalized population of children. Implementation strategies were selected based on the organization climate and included: multidisciplinary involvement and education, revised policies and procedures, a clinical algorithm and quick reference cards, automated computerized documentation and order sets, and activation of clinical expertise to the bedside. Implementation was evaluated by multiple methods. A total of 58 (14.5/6 months) extravasations were reported in the NICU over two years prior, compared to 19 in the 6-months post-implementation period. The number of reported extravasations treated with hyaluronidase increased from 9% (5/58) to 63% (12/19). An online survey was used to test provider’s baseline and 6-month post-implementation knowledge about hyaluronidase. A total of 175 pediatric staff participated in the baseline survey compared to 100 in the 6-month evaluation. Performance improved or remained > 90% on 10 of 10 knowledge questions. Treatment patterns showed increased use of evidence-based interventions for extravasations (hyaluronidase, elevation) and the average time from detection to treatment decreased from 125 minutes to 76 minutes. Process evaluations completed by point of care providers indicate that point of care providers were well-equipped to implement the guideline. This project demonstrates the use of guidelines and translational strategies to implement an evidence-based intervention and potentially improve outcomes related to IV extravasations.
See more of: Evidence-Based Practice Poster Session 2
See more of: Evidence-Based Practice Sessions: Oral Paper & Posters
See more of: Evidence-Based Practice Sessions: Oral Paper & Posters