OBTAINING ACCURATE BLOOD SAMPLING FROM A CENTRAL LINE DURING TOTAL PARENTERAL NUTRITION ADMINISTRATION: MULTIDISCIPLINARY TEAM APPROACH

2.50
Hdl Handle:
http://hdl.handle.net/10755/164987
Category:
Abstract
Type:
Presentation
Title:
OBTAINING ACCURATE BLOOD SAMPLING FROM A CENTRAL LINE DURING TOTAL PARENTERAL NUTRITION ADMINISTRATION: MULTIDISCIPLINARY TEAM APPROACH
Author(s):
Howlett, Kristie; Ford, Joshua
Author Details:
Kristie Howlett, RN, MS, CNS, OCN, Clinical Nurse Specialist, Sutter Roseville Medical Center, Roseville, California, USA, email: howletk@sutterhealth.org; Joshua Ford, RN
Abstract:
Clinical/Evidence Based Practice: Central Vascular Access Devices (VAD), placed to provide reliable access for administration of chemotherapy, transfusions, and numerous blood samplings, are common in the oncology patient. Our oncology nurses and the Peripherally Inserted Central Catheter (PICC) team, proactively identify the appropriate VAD to support ordered therapy, promote optimal outcomes, reduce length of stay, and reduce cost. In 2008 our laboratory reported an increase in the number of Central Line Nurse Collected Blood Specimens (CLNCBS) contaminated with Total Parenteral Nutrition (TPN). In the first 4 months of 2008, contaminated blood specimens from the oncology unit ranged from 14-22/month. Inaccurate/false results placed the patient at risk for potential misdiagnosis, altered therapies, potential medication errors, inappropriate electrolyte management and increased cost. We could find no literature to support a technique that would eliminate CLNCBS contamination. The purpose was to develop an accurate and consistent blood sampling process to eliminate CLNCBS contamination. The collaboration between the Oncology RNs, PICC team and Laboratory resulted in development of a clinical practice standard (CPS) addressing CLNCBS. The development of the new CPS included a review of policy and procedure, products, revision of Central line flushing protocol, flushing technique and identifying one lumen as the designated blood sampling lumen. Once a new practice was defined, a pilot project was implemented on the in-patient oncology unit. The PICC team trained super-users, who then provided one on one nurse training to all Oncology RN staff. The competency was developed in May and implemented in June, 2008. Prior to June 2008, the oncology unit was experiencing 14- 22 contaminated NCBS from central lines monthly. Since the implementation of the pilot, there have been zero contaminated CLNCBS on the oncology unit. Based on the pilot unit findings, this new process has been implemented hospital wide. The collaborative relationship with the PICC team and the laboratory resulted in improved collegiality among professional staff and increased communication through these relationships. This pilot project has resulted in increased staff, patient, and physician satisfaction by decreasing repeat laboratory collection and increasing accuracy. This multidisciplinary approach and collaboration between departments has strengthened our team approach to patient care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
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.titleOBTAINING ACCURATE BLOOD SAMPLING FROM A CENTRAL LINE DURING TOTAL PARENTERAL NUTRITION ADMINISTRATION: MULTIDISCIPLINARY TEAM APPROACHen_GB
dc.contributor.authorHowlett, Kristieen_US
dc.contributor.authorFord, Joshuaen_US
dc.author.detailsKristie Howlett, RN, MS, CNS, OCN, Clinical Nurse Specialist, Sutter Roseville Medical Center, Roseville, California, USA, email: howletk@sutterhealth.org; Joshua Ford, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164987-
dc.description.abstractClinical/Evidence Based Practice: Central Vascular Access Devices (VAD), placed to provide reliable access for administration of chemotherapy, transfusions, and numerous blood samplings, are common in the oncology patient. Our oncology nurses and the Peripherally Inserted Central Catheter (PICC) team, proactively identify the appropriate VAD to support ordered therapy, promote optimal outcomes, reduce length of stay, and reduce cost. In 2008 our laboratory reported an increase in the number of Central Line Nurse Collected Blood Specimens (CLNCBS) contaminated with Total Parenteral Nutrition (TPN). In the first 4 months of 2008, contaminated blood specimens from the oncology unit ranged from 14-22/month. Inaccurate/false results placed the patient at risk for potential misdiagnosis, altered therapies, potential medication errors, inappropriate electrolyte management and increased cost. We could find no literature to support a technique that would eliminate CLNCBS contamination. The purpose was to develop an accurate and consistent blood sampling process to eliminate CLNCBS contamination. The collaboration between the Oncology RNs, PICC team and Laboratory resulted in development of a clinical practice standard (CPS) addressing CLNCBS. The development of the new CPS included a review of policy and procedure, products, revision of Central line flushing protocol, flushing technique and identifying one lumen as the designated blood sampling lumen. Once a new practice was defined, a pilot project was implemented on the in-patient oncology unit. The PICC team trained super-users, who then provided one on one nurse training to all Oncology RN staff. The competency was developed in May and implemented in June, 2008. Prior to June 2008, the oncology unit was experiencing 14- 22 contaminated NCBS from central lines monthly. Since the implementation of the pilot, there have been zero contaminated CLNCBS on the oncology unit. Based on the pilot unit findings, this new process has been implemented hospital wide. The collaborative relationship with the PICC team and the laboratory resulted in improved collegiality among professional staff and increased communication through these relationships. This pilot project has resulted in increased staff, patient, and physician satisfaction by decreasing repeat laboratory collection and increasing accuracy. This multidisciplinary approach and collaboration between departments has strengthened our team approach to patient care.en_GB
dc.date.available2011-10-27T12:10:32Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:10:32Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan 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.-
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