Describing Saline Lock Usage Patterns of Patients Admitted to a Telemetry Unit: A Retrospective Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/157185
Category:
Abstract
Type:
Presentation
Title:
Describing Saline Lock Usage Patterns of Patients Admitted to a Telemetry Unit: A Retrospective Study
Author(s):
Szablewski, Steven; Thomas, Linda; Zuzelo, Patti; Morales, Ellen
Author Details:
Steven Szablewski, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA, email: sszablewski@hotmail.com; Linda Thomas; Patti Zuzelo; Ellen Morales
Abstract:
PURPOSE: This study was conducted to examine saline lock (SL) usage patterns of patients admitted with high-frequency medical diagnoses to a telemetry unit in order to determine the appropriateness of routine SL insertions and the acceptability of an evidenced-based decision tree stratifying SL insertion decisions based upon medical diagnosis and vein condition guided by professional expertise and patient preference. BACKGROUND: Traditionally, SLs have been routinely inserted & maintained in patients admitted to telemetry as a precaution in the event of dysrhythmias requiring emergent intravenous (IV) drug interventions. SLs are associated with risk because of their potential for infection & phlebitis as well as patient discomfort & injury. While risks associated with SLs have been examined, there remains very limited research on rates of SL use & no published standard of care regarding mandatory SL requirements. METHODS: This quantitative, retrospective descriptive study reviewed medical records of patients (N=341) ages 21-101 (M=65.69; SD=15.55) admitted to the telemetry unit over a three month period with one of the highest frequency admitting diagnoses: Acute Myocardial Infarction, Heart Failure, Syncope/Dizziness, & Chest Pain. Patient demographics, SL identifiers, & administered IV medications were transcribed by registered nurses using an electronic database. Classification of IV medications as either urgent or non-urgent was based upon the American Heart Association 2005 Guidelines for Emergency Cardiovascular Care. Descriptive and inferential analyses were performed using SPSS 15.0. RESULTS: While over a third of SLs were not used and over half were used non-urgently, 12.9% were used for the urgent delivery of medications. SLs were used most frequently for urgent delivery (22.9%) in patients with an admitting diagnosis of Heart Failure (HF). One-way ANOVA revealed significant differences by admitting diagnosis based upon inpatient day for first use of the SL (F=43.22; p<.000). SLs were used earliest in hospital stays of patients admitted with HF with a mean first day SL use of 1.71 (SD= 1.94). Chi-square analysis of the frequencies of urgent, non-urgent, or non-use of SLs found a greater than expected rate for non-use and non-urgent use (Chi-Square=76.41; df=2; p=.000). CONCLUSIONS: The traditional practice of continuous SL access for patients requiring telemetry requires further scrutiny. Findings suggest that a select number of patients require SLs for urgent delivery of medications. Implementation and evaluation of an evidenced-based algorithm may be useful in determining the need for SL placement in certain telemetry patients. Additional research is essential in determining if the benefits outweigh the risks associated with the insertion and maintenance of SLs.
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.titleDescribing Saline Lock Usage Patterns of Patients Admitted to a Telemetry Unit: A Retrospective Studyen_GB
dc.contributor.authorSzablewski, Stevenen_GB
dc.contributor.authorThomas, Lindaen_GB
dc.contributor.authorZuzelo, Pattien_GB
dc.contributor.authorMorales, Ellenen_GB
dc.author.detailsSteven Szablewski, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA, email: sszablewski@hotmail.com; Linda Thomas; Patti Zuzelo; Ellen Moralesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157185-
dc.description.abstractPURPOSE: This study was conducted to examine saline lock (SL) usage patterns of patients admitted with high-frequency medical diagnoses to a telemetry unit in order to determine the appropriateness of routine SL insertions and the acceptability of an evidenced-based decision tree stratifying SL insertion decisions based upon medical diagnosis and vein condition guided by professional expertise and patient preference. BACKGROUND: Traditionally, SLs have been routinely inserted &amp; maintained in patients admitted to telemetry as a precaution in the event of dysrhythmias requiring emergent intravenous (IV) drug interventions. SLs are associated with risk because of their potential for infection &amp; phlebitis as well as patient discomfort &amp; injury. While risks associated with SLs have been examined, there remains very limited research on rates of SL use &amp; no published standard of care regarding mandatory SL requirements. METHODS: This quantitative, retrospective descriptive study reviewed medical records of patients (N=341) ages 21-101 (M=65.69; SD=15.55) admitted to the telemetry unit over a three month period with one of the highest frequency admitting diagnoses: Acute Myocardial Infarction, Heart Failure, Syncope/Dizziness, &amp; Chest Pain. Patient demographics, SL identifiers, &amp; administered IV medications were transcribed by registered nurses using an electronic database. Classification of IV medications as either urgent or non-urgent was based upon the American Heart Association 2005 Guidelines for Emergency Cardiovascular Care. Descriptive and inferential analyses were performed using SPSS 15.0. RESULTS: While over a third of SLs were not used and over half were used non-urgently, 12.9% were used for the urgent delivery of medications. SLs were used most frequently for urgent delivery (22.9%) in patients with an admitting diagnosis of Heart Failure (HF). One-way ANOVA revealed significant differences by admitting diagnosis based upon inpatient day for first use of the SL (F=43.22; p<.000). SLs were used earliest in hospital stays of patients admitted with HF with a mean first day SL use of 1.71 (SD= 1.94). Chi-square analysis of the frequencies of urgent, non-urgent, or non-use of SLs found a greater than expected rate for non-use and non-urgent use (Chi-Square=76.41; df=2; p=.000). CONCLUSIONS: The traditional practice of continuous SL access for patients requiring telemetry requires further scrutiny. Findings suggest that a select number of patients require SLs for urgent delivery of medications. Implementation and evaluation of an evidenced-based algorithm may be useful in determining the need for SL placement in certain telemetry patients. Additional research is essential in determining if the benefits outweigh the risks associated with the insertion and maintenance of SLs.en_GB
dc.date.available2011-10-26T19:29:52Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:29:52Z-
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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