To Reduce the Incidence of Backache of Patients After Lumbar Puncture Examination Through Cross-Group Collaboration

Friday, 26 July 2019

Jui-Mei Chin, RN
L11G, Linkou Chang Gung Memorial Hospital, Taiwan, Taiwan Tapei, Taiwan
Chih-Hsuan Chen, BSN, RN
Linkou Chang Gung Memorial Hospital, Neurology Ward, Linkou Chang Gung Memorial Hospital, Taiwan, Taoyuan City, Taiwan
Hung-ju Chen, MSN
Neurology Ward, Linkou Chang Gung Memorial Hospital, Taiwan, TAOYUAN, Taiwan

Purpose:

Lumbar puncture is one of the common examinations for neurological patients, with an aim to measure intracranial pressure and diagnose diseases through extracting a small amount of or draining excess cerebrospinal fluid. Patients must lie flat for 6-8 hours after examination without a pillow, to avoid the occurrence of headache. Such position, however, will cause patients to have a backache, dysuria and other discomfort, and further undermine the patients’ willingness to lie flat and increase the workload of nursing personnel.so we use to Reduce the Incidence of Backache of Patients after Lumbar Puncture Examination through Cross-Group Collaboration

Methods:

A total of 68 patients received lumbar puncture examination in neurology wards from February 1, 2017 to July 31, 2017, and an incidence of backache of 91.2%, and an incidence of dysuria of 51.5% were recorded. Only 35.2% patients lay flat for exactly 6 hours. Cause analysis: patients will be prone to neck pain and backache if lying flat for too long. All patients after lumbar puncture examinations complained discomfort incurred from continuous lying flat due to the lack of activity guidelines and bed position aids in the process of lying flat.

Results:

After the post-lumbar puncture nursing criterion is revised jointly through teamwork, appropriate pillows and bed position aids are purchased, and patient lying-flat comfort monitoring indicator after lumbar puncture examination is developed, etc., the time for lying flat is reduced to 1 hour and patients can lie on a pillow and can bend their legs. The incidence of post-lumbar puncture backache of patients is reduced from 91.2% to 0%, the incidence of dysuria is reduced to 0%, and discomfortable symptoms of patients incurred from lying flat have been reduced significantly.

Conclusion:

Through further analysis on the possibility of increasing the incidence of headache or leakage of cerebrospinal fluid of patients due to reduction of time of lying flat, it is found that there is no significant difference in statistics of the time of lying flat and the incidence of headache, which is consistent with the result of reducing the incidence of headache in prolonged bed rest and short-term bed rest or immediate off-bed activity after lumbar puncture examination put forward by Rodriguez et al. (2013) in his systematic review. It is expected to improve the safety of patients, increase the convenience and benefits of clinical work, and further improve medical care quality through expanded and continuous medical collaboration.