Use of the Epidemiological Model to Describe Factors Present During Initiation of Prehospital Peripheral Intravenous Access in one Northwest U.S. Emergency Medical Service

2.50
Hdl Handle:
http://hdl.handle.net/10755/162767
Type:
Presentation
Title:
Use of the Epidemiological Model to Describe Factors Present During Initiation of Prehospital Peripheral Intravenous Access in one Northwest U.S. Emergency Medical Service
Abstract:
Use of the Epidemiological Model to Describe Factors Present During Initiation of Prehospital Peripheral Intravenous Access in one Northwest U.S. Emergency Medical Service
Conference Sponsor:Emergency Nurses Association
Conference Year:2000
Author:White, Virginia M., RN, MN, CEN
P.I. Institution Name:University of Washington, Tacoma
Contact Address:1900 Commerce Street, Tacoma, WA, 98402, USA
Contact Telephone:(360) 792-6710
Co-Authors:Sharon Gavin Fought and Ruth E. Rea
Purpose: Prehospital intravenous (IV) access is believed to possess greater risk for IV complications than in-hospital IV access. The degree to which factors proposed to influence patients' risks for IV complications are present during initiation of prehospital IV s has not been clearly described. The purpose of this study was to describe factors present during initiation of prehospital IVs in a northwest emergency medical service (EMS). The epidemiological model was chosen as the study framework for the established concepts of host (prehospital patient), agent (prehospital professional and the initiated IV) and environment (prehospital setting).

Design: A non-experimental, descriptive design was used.

Setting: Data collection from EMS professionals took place in a Level III, 17 -bed emergency department which averages 40,000 visits per year, located in the Puget Sound region.

Sample: EMS prehospital professionals and their adult patients age 18 years and older brought to the emergency department with EMS prehospital professional-initiated IVs constituted the population from which the convenience sample was obtained.

Methodology: The investigators developed a numerically coded, 13-item survey based on the epidemiological model. Survey queries addressed IV catheter size, number of IV attempts, patient age and gender, type of skin preparation used, and the prehospital professional's years experience initiating IV s. Prehospital professionals completed and returned 70 surveys (46.7% response rate). Content validity of the survey was established through an expert panel review. Analysis of the descriptive data was performed using the Statistical Package for Social Sciences.

Results: Using the epidemiological model as a framework, 52% of 'hosts' or patients were over 65 years old, with nearly equal percentages of males (48%) and females (52%), and most (78%) had intact skin. Many had medical problems, with diabetes (4%), vascular disease (13%) or multiple disorders (20%). IV catheters as 'agent' were most frequently 18 gauge (57%), with the antecubital fossa as the favored IV site (33%). IV access was successful in 80% of first attempts. The majority of prehospital professionals possessed greater than 5 years of IV experience (71%). There was IV attempts without prior skin cleansing (25%). With respect to the environment in which IV access occurred, it was most frequently described as 'well-lit' (71%), 'clean' (70%), 'warm' (84%), and dry (74%).

Conclusions: Several factors purported to influence patients' risks for IV complications were identified in this study. Further studies should be conducted to identify such factors in hospital-initiated IV access. [Research Poster Presentation]
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.titleUse of the Epidemiological Model to Describe Factors Present During Initiation of Prehospital Peripheral Intravenous Access in one Northwest U.S. Emergency Medical Serviceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162767-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Use of the Epidemiological Model to Describe Factors Present During Initiation of Prehospital Peripheral Intravenous Access in one Northwest U.S. Emergency Medical Service</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">2000</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">White, Virginia M., RN, MN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Washington, Tacoma</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1900 Commerce Street, Tacoma, WA, 98402, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(360) 792-6710</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">wolalla@worldnet.att.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sharon Gavin Fought and Ruth E. Rea</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Prehospital intravenous (IV) access is believed to possess greater risk for IV complications than in-hospital IV access. The degree to which factors proposed to influence patients' risks for IV complications are present during initiation of prehospital IV s has not been clearly described. The purpose of this study was to describe factors present during initiation of prehospital IVs in a northwest emergency medical service (EMS). The epidemiological model was chosen as the study framework for the established concepts of host (prehospital patient), agent (prehospital professional and the initiated IV) and environment (prehospital setting).<br/><br/>Design: A non-experimental, descriptive design was used.<br/><br/>Setting: Data collection from EMS professionals took place in a Level III, 17 -bed emergency department which averages 40,000 visits per year, located in the Puget Sound region.<br/><br/>Sample: EMS prehospital professionals and their adult patients age 18 years and older brought to the emergency department with EMS prehospital professional-initiated IVs constituted the population from which the convenience sample was obtained.<br/><br/>Methodology: The investigators developed a numerically coded, 13-item survey based on the epidemiological model. Survey queries addressed IV catheter size, number of IV attempts, patient age and gender, type of skin preparation used, and the prehospital professional's years experience initiating IV s. Prehospital professionals completed and returned 70 surveys (46.7% response rate). Content validity of the survey was established through an expert panel review. Analysis of the descriptive data was performed using the Statistical Package for Social Sciences.<br/><br/>Results: Using the epidemiological model as a framework, 52% of 'hosts' or patients were over 65 years old, with nearly equal percentages of males (48%) and females (52%), and most (78%) had intact skin. Many had medical problems, with diabetes (4%), vascular disease (13%) or multiple disorders (20%). IV catheters as 'agent' were most frequently 18 gauge (57%), with the antecubital fossa as the favored IV site (33%). IV access was successful in 80% of first attempts. The majority of prehospital professionals possessed greater than 5 years of IV experience (71%). There was IV attempts without prior skin cleansing (25%). With respect to the environment in which IV access occurred, it was most frequently described as 'well-lit' (71%), 'clean' (70%), 'warm' (84%), and dry (74%).<br/><br/>Conclusions: Several factors purported to influence patients' risks for IV complications were identified in this study. Further studies should be conducted to identify such factors in hospital-initiated IV access. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:47Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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