Outcomes of an Innovative Evidence-Based Project: Building a Difficult Access Team in an Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/621701
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Outcomes of an Innovative Evidence-Based Project: Building a Difficult Access Team in an Emergency Department
Author(s):
Baptiste, Diana Lyn; Maliszewski, Barbara; Whalen, Madeleine; Gardner, Heather; Sheinfeld, Rebecca
Lead Author STTI Affiliation:
Nu Beta
Author Details:
Diana Lyn Baptiste, DNP, MSN, RN, Professional Experience: 2015-Present -- Assistant Professor, Johns Hopkins University School of Nursing, Baltimore, MD 2015-Present - Evidence-based Practice Nurse, Emergency Medicine Department- Johns Hopkins Hospital, Baltimore, MD 2013-Present -- Faculty Associate, Johns Hopkins University School of Nursing, Baltimore, MD 2007-2013 -- Supplemental Staff Nurse--Greater Baltimore Medical Center, Towson, MD 2010-2011 -- Clinical Instructor--Johns Hopkins University School of Nursing, Baltimore, MD 2006-2009 - Supplemental Staff Nurse--Franklin Square Hospital, Baltimore, MD 2000-2006- Staff Nurse- Mercy Medical Center, Baltimore, MD Volunteers on Medical Missions in Haiti Has published and presented internationally Sigma Theta Tau International Society of Nursing, Nu Beta Chapter, President Author Summary: Dr. Baptiste has had a 15-year nursing career devoted to caring for adults, specializing in cardiovascular prevention and health care. She has recently joined the Johns Hopkins Hospital Emergency Medicine Leadership Team, assisting nurse leaders working on various quality improvement projects. Dr. Baptiste has published in areas of heart failure and cultural humility. She has presented nationally and internationally in areas of nursing education with a promoting nurse competencies in acute-care clinical settings.
Abstract:

Background/Introduction:

Emergency departments across the nation face challenges of longer lengths of stay due to increased volumes and patient acuity. Intravenous (IV) access is vital to emergency care, and a large proportion of patients seen in the Emergency Department have difficult venous access, resulting in patient care delays. Difficult venous access (DVA) is identified as a condition among individuals who most often require 2 or more attempts for successful IV access, leading to an increased length of time needed to obtain IV access, or may require special interventions to establish peripheral IV access.

Purpose/Objectives:

The objective of this project was to determine if a dedicated difficult access team will decrease the number of attempts and amount of time for successfully obtaining IV access in difficult venous access patients.

 Methods 

The intervention included the implementation of a difficult access clinical technician team. The specialized team was initiated as a pilot to determine whether use of a specialized team would decrease number of attempts and amount of time for successfully obtaining IV access in difficult venous access patients. This study included convenience samples of patients visiting the adult emergency department with a provider order to place IV access. We compared the mean number of attempts and time it took for obtaining successful IV access for the pre and post- intervention periods, among two samples.

Results:

Prior to the intervention, there were 3.8 (SD 1.18) mean number of attempts for obtaining IV access for (N=52) patients who were identified to have DVA. After the intervention, a mean number of attempts per DVA patient was reported at 1.2 (0.47). A significant difference (p= <0.05; CI 95% 2.25-2.94) was found between the pre intervention and post intervention mean number of successful attempts but no significant reduction in the time it takes to obtain successful IV access among these two samples.

Conclusion:

IV access is an essential procedure for the assessment and treatment of patients seeking health care in the emergency department. It important to consider a feasible solution for managing DVA among patients. Our findings suggest that implementation of a dedicated difficult access team can decrease the time and number of attempts necessary for obtaining IV access in individuals with difficult venous access. Further investigation is necessary to determine variables that impact increased time to obtain successful IV access in patients with difficult venous access.

Keywords:
Difficult Venous Access; Emergency Department; Vascular Access
Repository Posting Date:
6-Jul-2017
Date of Publication:
6-Jul-2017
Other Identifiers:
INRC17PST1
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleOutcomes of an Innovative Evidence-Based Project: Building a Difficult Access Team in an Emergency Departmenten_US
dc.contributor.authorBaptiste, Diana Lynen
dc.contributor.authorMaliszewski, Barbaraen
dc.contributor.authorWhalen, Madeleineen
dc.contributor.authorGardner, Heatheren
dc.contributor.authorSheinfeld, Rebeccaen
dc.contributor.departmentNu Betaen
dc.author.detailsDiana Lyn Baptiste, DNP, MSN, RN, Professional Experience: 2015-Present -- Assistant Professor, Johns Hopkins University School of Nursing, Baltimore, MD 2015-Present - Evidence-based Practice Nurse, Emergency Medicine Department- Johns Hopkins Hospital, Baltimore, MD 2013-Present -- Faculty Associate, Johns Hopkins University School of Nursing, Baltimore, MD 2007-2013 -- Supplemental Staff Nurse--Greater Baltimore Medical Center, Towson, MD 2010-2011 -- Clinical Instructor--Johns Hopkins University School of Nursing, Baltimore, MD 2006-2009 - Supplemental Staff Nurse--Franklin Square Hospital, Baltimore, MD 2000-2006- Staff Nurse- Mercy Medical Center, Baltimore, MD Volunteers on Medical Missions in Haiti Has published and presented internationally Sigma Theta Tau International Society of Nursing, Nu Beta Chapter, President Author Summary: Dr. Baptiste has had a 15-year nursing career devoted to caring for adults, specializing in cardiovascular prevention and health care. She has recently joined the Johns Hopkins Hospital Emergency Medicine Leadership Team, assisting nurse leaders working on various quality improvement projects. Dr. Baptiste has published in areas of heart failure and cultural humility. She has presented nationally and internationally in areas of nursing education with a promoting nurse competencies in acute-care clinical settings.en
dc.identifier.urihttp://hdl.handle.net/10755/621701-
dc.description.abstract<p><strong>Background/Introduction:</strong></p> <p>Emergency departments across the nation face challenges of longer lengths of stay due to increased volumes and patient acuity. Intravenous (IV) access is vital to emergency care, and a large proportion of patients seen in the Emergency Department have difficult venous access, resulting in patient care delays. Difficult venous access (DVA) is identified as a condition among individuals who most often require 2 or more attempts for successful IV access, leading to an increased length of time needed to obtain IV access, or may require special interventions to establish peripheral IV access.</p> <p><strong>Purpose/Objectives:</strong></p> <p>The objective of this project was to determine if a dedicated difficult access team will decrease the number of attempts and amount of time for successfully obtaining IV access in difficult venous access patients.<strong></strong></p> <p><strong> Methods </strong></p> <p>The intervention included the implementation of a difficult access clinical technician team. The specialized team was initiated as a pilot to determine whether use of a specialized team would decrease number of attempts and amount of time for successfully obtaining IV access in difficult venous access patients. This study included convenience samples of patients visiting the adult emergency department with a provider order to place IV access. We compared the mean number of attempts and time it took for obtaining successful IV access for the pre and post- intervention periods, among two samples.</p> <p><strong>Results:</strong></p> <p>Prior to the intervention, there were 3.8 (SD 1.18) mean number of attempts for obtaining IV access for (N=52) patients who were identified to have DVA. After the intervention, a mean number of attempts per DVA patient was reported at 1.2 (0.47). A significant difference (<em>p</em>= <0.05; CI 95% 2.25-2.94) was found between the pre intervention and post intervention mean number of successful attempts but no significant reduction in the time it takes to obtain successful IV access among these two samples.<strong></strong></p> <p><strong>Conclusion:</strong></p> <p>IV access is an essential procedure for the assessment and treatment of patients seeking health care in the emergency department. It important to consider a feasible solution for managing DVA among patients. Our findings suggest that implementation of a dedicated difficult access team can decrease the time and number of attempts necessary for obtaining IV access in individuals with difficult venous access. Further investigation is necessary to determine variables that impact increased time to obtain successful IV access in patients with difficult venous access.</p>en
dc.subjectDifficult Venous Accessen
dc.subjectEmergency Departmenten
dc.subjectVascular Accessen
dc.date.available2017-07-06T20:37:04Z-
dc.date.issued2017-07-06-
dc.date.accessioned2017-07-06T20:37:04Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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