2.50
Hdl Handle:
http://hdl.handle.net/10755/306608
Category:
Abstract
Type:
Poster
Title:
Step by Step in Pictures: Easing Angst in Central Venous Pressure Monitoring
Author(s):
Kane, Joanne; Robin, Nancy M.; Brennan, Denise
Lead Author STTI Affiliation:
Non-member
Author Details:
Joanne Kane, RN, CEN, jodoh20@yahoo.com; Nancy M. Robin, MEd, RN, CEN; Denise Brennan, MS, RN, CNL
Abstract:

Evidence-based Practice Abstract

Purpose: With the Surviving Sepsis Campaign emphasis to identify and treat severe sepsis and septic shock, many non-trauma emergency departments (ED) were challenged to train staff to set up and monitor central venous pressure. This is often a low volume procedure which can be problematic for emergency nurses who infrequently asked to monitor central venous pressure (CVP). ED nurses found the six page hospital policy and procedure difficult to follow. Pictures seemed to be the answer. A need was identified to assist emergency department staff with quick and efficient CVP monitoring equipment set-up. A pictorial reference aid was developed and implemented.

Design: Staff development project.

Setting: Urban teaching hospital emergency department with 60,000 visits.

Participants: Emergency Department staff nurses, Nurse Educators.

Methods: Nurses truly wanted to feel competent and confident when setting up for CVP monitoring. Previous training methods included yearly training fairs, one on one remediation, small reference sheets, and staff resources from the critical care unit. In order to provide a hands-on resource which could walk the nurses step by step through the process, a pictorial guide was developed. Photographs were taken of equipment and mannequin was used to simulate a patient encounter. Step-by-step simplified written directions accompanied the photographs on a laminated card placed in the CVP carts in the ED critical care rooms. The laminated pictorial reference card was reviewed by nurses. During the annual competency fair, nurses were allowed to follow the steps on the reference aid. Each nurse was asked to demonstrate the skill using CVP monitoring equipment, a simulation mannequin, and laminated reference aid to show competence in this skill.

Results: Although all nurses had practiced setting up the equipment during previous training sessions, only those nurses who had past critical care experience voiced that they felt very comfortable setting up CVP monitoring. In the ED 2012 Needs Assessment, nurses ranked sixty six procedures on a scale of 1-5 (1-very uncomfortable; 2-uncomfortable; 3-somewhat comfortable; 4 comfortable; 5-very comfortable.) CVP monitoring had the second to lowest comfort level with a score of 2.53. The lowest was precipitous delivery. When allowed to use the laminated card at the competency fair, all eighty eight nurses were able to follow the pictures and demonstrate competence. Staff verbalized positive feedback to reference aid ease of use and efficacy in clinical setting. The CVP station objective of demonstrating competence received the highest ranking of outstanding or exceeded expectations. In 2013, a needs assessment will be administered to formally obtain comparison data.

Implications: Septic patients should receive initial CVP reading in Emergency Department for accurate diagnosis and treatment plan. Emergency Department staff nurses should be competent at CVP monitoring set up. The strategy of using a pictorial step by step reference cards has many future implications for low volume procedures.

Keywords:
Pictorial help with Central Venous Pressure Monitoring
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleStep by Step in Pictures: Easing Angst in Central Venous Pressure Monitoringen_GB
dc.contributor.authorKane, Joanneen_GB
dc.contributor.authorRobin, Nancy M.en_GB
dc.contributor.authorBrennan, Deniseen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsJoanne Kane, RN, CEN, jodoh20@yahoo.com; Nancy M. Robin, MEd, RN, CEN; Denise Brennan, MS, RN, CNLen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306608-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: With the Surviving Sepsis Campaign emphasis to identify and treat severe sepsis and septic shock, many non-trauma emergency departments (ED) were challenged to train staff to set up and monitor central venous pressure. This is often a low volume procedure which can be problematic for emergency nurses who infrequently asked to monitor central venous pressure (CVP). ED nurses found the six page hospital policy and procedure difficult to follow. Pictures seemed to be the answer. A need was identified to assist emergency department staff with quick and efficient CVP monitoring equipment set-up. A pictorial reference aid was developed and implemented.</p><p>Design: Staff development project.</p><p>Setting: Urban teaching hospital emergency department with 60,000 visits.</p><p>Participants: Emergency Department staff nurses, Nurse Educators.</p><p>Methods: Nurses truly wanted to feel competent and confident when setting up for CVP monitoring. Previous training methods included yearly training fairs, one on one remediation, small reference sheets, and staff resources from the critical care unit. In order to provide a hands-on resource which could walk the nurses step by step through the process, a pictorial guide was developed. Photographs were taken of equipment and mannequin was used to simulate a patient encounter. Step-by-step simplified written directions accompanied the photographs on a laminated card placed in the CVP carts in the ED critical care rooms. The laminated pictorial reference card was reviewed by nurses. During the annual competency fair, nurses were allowed to follow the steps on the reference aid. Each nurse was asked to demonstrate the skill using CVP monitoring equipment, a simulation mannequin, and laminated reference aid to show competence in this skill.</p><p>Results: Although all nurses had practiced setting up the equipment during previous training sessions, only those nurses who had past critical care experience voiced that they felt very comfortable setting up CVP monitoring. In the ED 2012 Needs Assessment, nurses ranked sixty six procedures on a scale of 1-5 (1-very uncomfortable; 2-uncomfortable; 3-somewhat comfortable; 4 comfortable; 5-very comfortable.) CVP monitoring had the second to lowest comfort level with a score of 2.53. The lowest was precipitous delivery. When allowed to use the laminated card at the competency fair, all eighty eight nurses were able to follow the pictures and demonstrate competence. Staff verbalized positive feedback to reference aid ease of use and efficacy in clinical setting. The CVP station objective of demonstrating competence received the highest ranking of outstanding or exceeded expectations. In 2013, a needs assessment will be administered to formally obtain comparison data.</p><p>Implications: Septic patients should receive initial CVP reading in Emergency Department for accurate diagnosis and treatment plan. Emergency Department staff nurses should be competent at CVP monitoring set up. The strategy of using a pictorial step by step reference cards has many future implications for low volume procedures.</p>en_GB
dc.subjectPictorial help with Central Venous Pressure Monitoringen_GB
dc.date.available2013-12-09T17:00:40Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:40Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_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.en_GB
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