Let the Data Speak: Decreasing Hemolysis through Education, Practice and Disclosure

2.50
Hdl Handle:
http://hdl.handle.net/10755/162389
Type:
Presentation
Title:
Let the Data Speak: Decreasing Hemolysis through Education, Practice and Disclosure
Abstract:
Let the Data Speak: Decreasing Hemolysis through Education, Practice and Disclosure
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:McGrath, Jayne, RN, MS, CCRN, CEN
P.I. Institution Name:University of Wisconsin Hospital & Clinics
Title:Clinical Nurse Specialist
Contact Address:600 Highland Avenue F2/221, Madison, WI, 53792-3280, USA
Contact Telephone:608-890-9098
Co-Authors:Pete Rankin, RN, BSN
[ENA Annual Conference - Evidence-based Practice Presentation]
Purpose: High hemolysis rates continue to plague emergency departments (ED). When a specimen is hemolyzed, additional time and resources are required to obtain a new lab specimen from the patient, further delaying patient throughput in an already busy and crowded ED. Causes and determination of hemolysis appear variable, making improvement of hemolysis rates more challenging to address. Different approaches to curbing the soaring hemolysis rates yielded small sustainable results. The purpose of this project was to acquire longevity in decreased hemolysis rates.
Design: The project was developed as a quality improvement project to improve the ED's overall hemolysis rate. Collected data was analyzed in terms of progress towards the goal. The benchmark for the EDÆs hemolysis rate is < 8%.
Setting: The 29-bed ED, a Level-1 adult and pediatric trauma center is a Midwestern academic medical center. There is an average of 45,000 patient visits per year.
Participants/Subjects: All venipunctures in the ED are performed by ED staff. Staff is comprised of Registered Nurses (RN) and Emergency Department Technicians (ED Tech).

Methods: The project involved monthly data collection by lab personnel on department and individual hemolysis rates. Interventions included literature review, education, posting visuals reminders, testing different equipment, and posting results on the ED intranet site. The ED intranet site is a secure site that only ED staff can access.

Results: For most of 2007, and continuing through March of 2008, the hemolysis rate in the ED fluctuated between 11 and 15%. After individual hemolysis rates were posted on the intranet site, the hemolysis rate for April, May and June decreased to approximately 7%. The posted monthly graphs became a source of motivation for many, and the ED hemolysis rate decreased quickly. For almost 2 years, the hemolysis rate has remained below the benchmark.

Implications: Changing practice in clinical settings is challenging. Varied experience levels of staff and different techniques for lab draws made improving hemolysis rates difficult. A literature review revealed inconsistent findings and recommendations. Most staff had only been given anecdotal evidence of the efficacy of their individual techniques. No trend analysis had ever been conducted on individual rates.

The implications for change in clinical practice are great. Through posting hemolysis rates on the EDÆs intranet site, staff could view not only their rates but how their data compared to the rates of their peers. Some staff, who were not receptive to learning how to decrease hemolysis with venipuncture, began asking others (with a posted lower hemolysis rate) for help in improving their hemolysis rates. Staff were reassured that they would not be penalized for having a high rate. A transparent disclosure of data can be applied in many settings such as compliance in regulatory requirements, educational attendance, and professional certifications.

The literature has cited that clinical practice is often changed through a variety of methods and reinforcements. Using technology to provide specific and timely feedback served as a catalyst for lasting improvement in clinical practice.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleLet the Data Speak: Decreasing Hemolysis through Education, Practice and Disclosureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162389-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Let the Data Speak: Decreasing Hemolysis through Education, Practice and Disclosure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McGrath, Jayne, RN, MS, CCRN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Wisconsin Hospital &amp; Clinics</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">600 Highland Avenue F2/221, Madison, WI, 53792-3280, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">608-890-9098</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jmcgrath@uwhealth.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Pete Rankin, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation] <br/>Purpose: High hemolysis rates continue to plague emergency departments (ED). When a specimen is hemolyzed, additional time and resources are required to obtain a new lab specimen from the patient, further delaying patient throughput in an already busy and crowded ED. Causes and determination of hemolysis appear variable, making improvement of hemolysis rates more challenging to address. Different approaches to curbing the soaring hemolysis rates yielded small sustainable results. The purpose of this project was to acquire longevity in decreased hemolysis rates. <br/>Design: The project was developed as a quality improvement project to improve the ED's overall hemolysis rate. Collected data was analyzed in terms of progress towards the goal. The benchmark for the ED&AElig;s hemolysis rate is &lt; 8%.<br/>Setting: The 29-bed ED, a Level-1 adult and pediatric trauma center is a Midwestern academic medical center. There is an average of 45,000 patient visits per year. <br/>Participants/Subjects: All venipunctures in the ED are performed by ED staff. Staff is comprised of Registered Nurses (RN) and Emergency Department Technicians (ED Tech).<br/><br/>Methods: The project involved monthly data collection by lab personnel on department and individual hemolysis rates. Interventions included literature review, education, posting visuals reminders, testing different equipment, and posting results on the ED intranet site. The ED intranet site is a secure site that only ED staff can access. <br/><br/>Results: For most of 2007, and continuing through March of 2008, the hemolysis rate in the ED fluctuated between 11 and 15%. After individual hemolysis rates were posted on the intranet site, the hemolysis rate for April, May and June decreased to approximately 7%. The posted monthly graphs became a source of motivation for many, and the ED hemolysis rate decreased quickly. For almost 2 years, the hemolysis rate has remained below the benchmark. <br/><br/>Implications: Changing practice in clinical settings is challenging. Varied experience levels of staff and different techniques for lab draws made improving hemolysis rates difficult. A literature review revealed inconsistent findings and recommendations. Most staff had only been given anecdotal evidence of the efficacy of their individual techniques. No trend analysis had ever been conducted on individual rates. <br/><br/>The implications for change in clinical practice are great. Through posting hemolysis rates on the ED&AElig;s intranet site, staff could view not only their rates but how their data compared to the rates of their peers. Some staff, who were not receptive to learning how to decrease hemolysis with venipuncture, began asking others (with a posted lower hemolysis rate) for help in improving their hemolysis rates. Staff were reassured that they would not be penalized for having a high rate. A transparent disclosure of data can be applied in many settings such as compliance in regulatory requirements, educational attendance, and professional certifications.<br/><br/>The literature has cited that clinical practice is often changed through a variety of methods and reinforcements. Using technology to provide specific and timely feedback served as a catalyst for lasting improvement in clinical practice. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:22Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:22Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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