2.50
Hdl Handle:
http://hdl.handle.net/10755/157172
Category:
Abstract
Type:
Presentation
Title:
An Evidence-Based Study on the Minimum Volume of Blood Wastage from Arterial Lines
Author(s):
Rodriguez, Wanda; Stone, Denise; Kane, Joyce; McCarty, Doreen; Nolan, Stephanie; O'Sullivan, Mary
Author Details:
Wanda Rodriguez, Memorial Sloan-Kettering Cancer Center, New York, New York, USA, email: rodriguw@mskcc.org; Denise Stone; Joyce Kane; Doreen McCarty; Stephanie Nolan; Mary O'Sullivan
Abstract:
PURPOSE: Laboratory testing continues to be a preventable source of blood loss in critically ill oncology patients. Factors contributing to nosocomial blood loss include frequent testing, lack of standards leading to inconsistent practices, and frequent use of arterial catheters. The Critical Care Evidence Based Practice Committee wanted to standardize the minimum blood volume wasted from arterial lines prior to specimen collection. We sought strategies to minimize waste volume from arterial lines. Description: Fifty articles from evidence-based databases were reviewed to determine if current practices or standards exist regarding the minimum volume of blood wasted from arterial lines during specimen collection. There were a limited number of meta-analysis, randomized experimental design, quasi-experimental and non-experimental studies related to blood- conserving mechanisms. Expert opinions, outside institutional practices, and observation of current practice at our institution were evaluated. The Stetler Model was used to rank the evidence. Literature recommends using a blood conserving device or equating the discard volume to double the dead space of the arterial line from the catheter tip to the sampling port. Given the compromised immunity of patients in an oncology center, it was determined that a closed system was not optimal for our institution. Based on the research, 3ml was calculated to be double the dead space, thus a dedicated 3ml waste tube was our solution to achieve standardization. These findings were presented to our multidisciplinary partners in the ICU, PACU and Clinical Laboratories. Consensus was achieved and approval was given to implement a dedicated 3ml waste tube in critical care areas. EVALUATION: Implementation of this practice change has provided standardization and decreased our current discard volume from 9ml to 3ml. In addition to minimizing the waste volume, there are numerous safety advantages of the dedicated waste tube. It is plastic as opposed to glass and it is distinct from our current inventory of laboratory tubes so to avoid being mistakenly analyzed by the laboratory as a diagnostic test. The waste tube is significantly more cost effective than the test tube formerly used for wasting blood. The use of a dedicated 3 ml waste tube has allowed us to maintain accurate test results while minimizing blood loss to the critically ill patient.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleAn Evidence-Based Study on the Minimum Volume of Blood Wastage from Arterial Linesen_GB
dc.contributor.authorRodriguez, Wandaen_GB
dc.contributor.authorStone, Deniseen_GB
dc.contributor.authorKane, Joyceen_GB
dc.contributor.authorMcCarty, Doreenen_GB
dc.contributor.authorNolan, Stephanieen_GB
dc.contributor.authorO'Sullivan, Maryen_GB
dc.author.detailsWanda Rodriguez, Memorial Sloan-Kettering Cancer Center, New York, New York, USA, email: rodriguw@mskcc.org; Denise Stone; Joyce Kane; Doreen McCarty; Stephanie Nolan; Mary O'Sullivanen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157172-
dc.description.abstractPURPOSE: Laboratory testing continues to be a preventable source of blood loss in critically ill oncology patients. Factors contributing to nosocomial blood loss include frequent testing, lack of standards leading to inconsistent practices, and frequent use of arterial catheters. The Critical Care Evidence Based Practice Committee wanted to standardize the minimum blood volume wasted from arterial lines prior to specimen collection. We sought strategies to minimize waste volume from arterial lines. Description: Fifty articles from evidence-based databases were reviewed to determine if current practices or standards exist regarding the minimum volume of blood wasted from arterial lines during specimen collection. There were a limited number of meta-analysis, randomized experimental design, quasi-experimental and non-experimental studies related to blood- conserving mechanisms. Expert opinions, outside institutional practices, and observation of current practice at our institution were evaluated. The Stetler Model was used to rank the evidence. Literature recommends using a blood conserving device or equating the discard volume to double the dead space of the arterial line from the catheter tip to the sampling port. Given the compromised immunity of patients in an oncology center, it was determined that a closed system was not optimal for our institution. Based on the research, 3ml was calculated to be double the dead space, thus a dedicated 3ml waste tube was our solution to achieve standardization. These findings were presented to our multidisciplinary partners in the ICU, PACU and Clinical Laboratories. Consensus was achieved and approval was given to implement a dedicated 3ml waste tube in critical care areas. EVALUATION: Implementation of this practice change has provided standardization and decreased our current discard volume from 9ml to 3ml. In addition to minimizing the waste volume, there are numerous safety advantages of the dedicated waste tube. It is plastic as opposed to glass and it is distinct from our current inventory of laboratory tubes so to avoid being mistakenly analyzed by the laboratory as a diagnostic test. The waste tube is significantly more cost effective than the test tube formerly used for wasting blood. The use of a dedicated 3 ml waste tube has allowed us to maintain accurate test results while minimizing blood loss to the critically ill patient.en_GB
dc.date.available2011-10-26T19:29:08Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:29:08Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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