2.50
Hdl Handle:
http://hdl.handle.net/10755/164036
Category:
Abstract
Type:
Presentation
Title:
Development & Implementation of an Evidenced-based Nitric Oxide Practice Guideline
Author(s):
Levenduski, Michalena
Author Details:
Michalena Levenduski, MSN, RNC, Pinnacle Health System, Harrisburg, Pennsylvania, USA, email: nacnsorg@nacns.org
Abstract:
Purpose/Objectives: The purpose of this presentation is to explain the development & implementation of an evidences-based guideline related to the administration and care of a neonate receiving nitric oxide. The objectives are: (1) develop & implement a multidisciplinary practice guideline to manage neonates receiving nitric oxide (2) evaluate the consistency and standardization of the delivery of care (3) describe the Clinical Nurse Specialist's influence in the development & implementation of the practice guideline. Background/Rationale: INOmax is "the first, and only nitric oxide approved by the FDA, in conjunction with ventilatory support and other appropriate agents, for the treatment of term or near term neonates (>34 weeks gestation) with hypoxic respiratory failure associated with clinical and echocardiographic evidence of pulmonary hypertension". The rationale is to develop and implement a practice guideline based upon research. Description of the Project: The administration of nitric oxide for the treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN) has demonstrated a decreased need and use of extracorporeal membrane oxygenation and a reduced occurrence of chronic lung disease. 11% of the >4000 infants delivered at a large health care system are admitted to the Neonatal Intensive Care Unit (NICU). 1% of those admissions are admitted with the diagnosis of PPHN. The administration if nitric oxide for the treatment of PPHN was not available and neonates were transported to another facility. In order to enhance patient care, decrease risk factors associated with transport, and improve customer relations, a multidisciplinary team consisting of neonatology, nursing, respiratory therapy, and pharmacy convened to discuss the feasibility of providing this very innovative service. A unanimous decision was reached whereby nitric oxide therapy would be available to this appropriate population. The NICU CNS and Respiratory Therapy Educator provide extensive and comprehensive educational inservices to respective staff members in June & July 2003. Components of the educational offering included: review of Persistent Pulmonary Hypertension of the Newborn (PPHN), description of nitric oxide, indications for use, dosage/administration, nursing implications, and complications. The target date for the implementation of providing nitric oxide was set for August 2003. Outcomes: A multidisciplinary practice guideline to manage neonates receiving nitric oxide was developed & implemented. Interpretation/Conclusion: The practice guideline was developed with ease. It has been however, very difficult to maintain clinical competency due to the decreased number of patients admitted with the diagnosis of PPHN that require the administration of nitric oxide. Implications for Nursing Practice: To maintain consistency and standardization of the delivery of care, the CNS will review all aspects of nitric oxide administration with all NICU staff members during mandatory NICU Education Day 2004.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Century
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
San Antonio, Texas, USA
Description:
Conference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, 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_US
dc.typePresentationen_GB
dc.titleDevelopment & Implementation of an Evidenced-based Nitric Oxide Practice Guidelineen_GB
dc.contributor.authorLevenduski, Michalenaen_US
dc.author.detailsMichalena Levenduski, MSN, RNC, Pinnacle Health System, Harrisburg, Pennsylvania, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164036-
dc.description.abstractPurpose/Objectives: The purpose of this presentation is to explain the development & implementation of an evidences-based guideline related to the administration and care of a neonate receiving nitric oxide. The objectives are: (1) develop & implement a multidisciplinary practice guideline to manage neonates receiving nitric oxide (2) evaluate the consistency and standardization of the delivery of care (3) describe the Clinical Nurse Specialist's influence in the development & implementation of the practice guideline. Background/Rationale: INOmax is "the first, and only nitric oxide approved by the FDA, in conjunction with ventilatory support and other appropriate agents, for the treatment of term or near term neonates (>34 weeks gestation) with hypoxic respiratory failure associated with clinical and echocardiographic evidence of pulmonary hypertension". The rationale is to develop and implement a practice guideline based upon research. Description of the Project: The administration of nitric oxide for the treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN) has demonstrated a decreased need and use of extracorporeal membrane oxygenation and a reduced occurrence of chronic lung disease. 11% of the >4000 infants delivered at a large health care system are admitted to the Neonatal Intensive Care Unit (NICU). 1% of those admissions are admitted with the diagnosis of PPHN. The administration if nitric oxide for the treatment of PPHN was not available and neonates were transported to another facility. In order to enhance patient care, decrease risk factors associated with transport, and improve customer relations, a multidisciplinary team consisting of neonatology, nursing, respiratory therapy, and pharmacy convened to discuss the feasibility of providing this very innovative service. A unanimous decision was reached whereby nitric oxide therapy would be available to this appropriate population. The NICU CNS and Respiratory Therapy Educator provide extensive and comprehensive educational inservices to respective staff members in June & July 2003. Components of the educational offering included: review of Persistent Pulmonary Hypertension of the Newborn (PPHN), description of nitric oxide, indications for use, dosage/administration, nursing implications, and complications. The target date for the implementation of providing nitric oxide was set for August 2003. Outcomes: A multidisciplinary practice guideline to manage neonates receiving nitric oxide was developed & implemented. Interpretation/Conclusion: The practice guideline was developed with ease. It has been however, very difficult to maintain clinical competency due to the decreased number of patients admitted with the diagnosis of PPHN that require the administration of nitric oxide. Implications for Nursing Practice: To maintain consistency and standardization of the delivery of care, the CNS will review all aspects of nitric oxide administration with all NICU staff members during mandatory NICU Education Day 2004.en_GB
dc.date.available2011-10-27T11:40:47Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:40:47Z-
dc.conference.date2004en_US
dc.conference.name2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Centuryen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.descriptionConference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USAen_US
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.en_US
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