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Methods: Education was developed and distributed, and facilitators were engaged on four units. Patient satisfaction regarding IV insertion was measured on a 1-10 scale comparing use of buffered lidocaine to non-use on outcomes. The effect of education and facilitation on practice uptake was obtained from IV start card data documenting use of buffered lidocaine. As a measure of practice sustainability, nurses on the study units completed a before and after implementation survey.
Results: A total of 109 IV start cards were collected from the four study units in 2012 and were compared with baseline data. Two units demonstrated a significant increase in the use of buffered lidocaine. Unit 1 increased from 19% to 65% (p<0.05) and Unit 2 from 18% to 41% (p=0.0084). Education surveys revealed no significant relationship between education and buffered lidocaine use when comparing pre-and post survey results. Mean satisfaction for patients receiving buffered lidocaine was 8.09 (SD 2.6, 95% CI 7.390-8.89) while the mean score for patients not receiving buffered lidocaine was 6.70 (SD 3.1, 95% CI 5.78-7.62). This difference was statistically significant (t=-2.305, df=87.166, p=0.024).
Conclusion: The CoMET demonstrated some success at improving outcomes and the sustainability of practice as evidenced by higher levels of patient satisfaction with IV insertions when buffered lidocaine was used. Successful practice uptake and sustainability was demonstrated on two of the four units. The failure of the education to demonstrate a difference in nurses’ knowledge or practice suggests that other factors may have impacted practice uptake.