Intravenous Access in Gastrointestinal Hemorrhage: A Multidisciplinary Quality Improvement Initiative Led by Emergency Department Nurses and Internal Medicine Physicians.
Academic Medical Centers
Acute Disease
/ therapy
Administration, Intravenous
Aged
Catheters
Emergency Nursing
/ education
Emergency Service, Hospital
/ organization & administration
Female
Gastrointestinal Hemorrhage
/ therapy
Humans
Internal Medicine
/ education
Male
Physicians
Practice Guidelines as Topic
/ standards
Quality Improvement
/ organization & administration
Retrospective Studies
Journal
Journal of nursing care quality
ISSN: 1550-5065
Titre abrégé: J Nurs Care Qual
Pays: United States
ID NLM: 9200672
Informations de publication
Date de publication:
Historique:
entrez:
21
5
2020
pubmed:
21
5
2020
medline:
3
2
2021
Statut:
ppublish
Résumé
The management of acute gastrointestinal hemorrhage (GIH) is focused on early resuscitation through 2 large-bore intravenous (2LBIV) catheters, although adherence to this recommendation is low. Of 100 patients hospitalized with GIH in 2017, only 14 received 2LBIV access. The goal of this study was to improve this measure. A multidisciplinary team used the DMAIC (define, measure, analyze, improve, and control) framework to perform a quality improvement initiative. The team used quality tools including a stakeholder survey, swimlane diagram, and fishbone diagram. The first intervention involved education of the hospitalists directing admissions, and the second intervention involved education of emergency department (ED) physicians and nurses regarding the importance of 2LBIV placement. Following the second intervention, there was a substantial increase in 2LBIV placement to 37 of 86 (43%). Carefully directed education of ED physicians and nurses with monthly feedback was effective in improving appropriate intravenous placement in patients with GIH.
Sections du résumé
BACKGROUND
BACKGROUND
The management of acute gastrointestinal hemorrhage (GIH) is focused on early resuscitation through 2 large-bore intravenous (2LBIV) catheters, although adherence to this recommendation is low.
LOCAL PROBLEM
OBJECTIVE
Of 100 patients hospitalized with GIH in 2017, only 14 received 2LBIV access. The goal of this study was to improve this measure.
METHODS
METHODS
A multidisciplinary team used the DMAIC (define, measure, analyze, improve, and control) framework to perform a quality improvement initiative.
INTERVENTIONS
METHODS
The team used quality tools including a stakeholder survey, swimlane diagram, and fishbone diagram. The first intervention involved education of the hospitalists directing admissions, and the second intervention involved education of emergency department (ED) physicians and nurses regarding the importance of 2LBIV placement.
RESULTS
RESULTS
Following the second intervention, there was a substantial increase in 2LBIV placement to 37 of 86 (43%).
CONCLUSIONS
CONCLUSIONS
Carefully directed education of ED physicians and nurses with monthly feedback was effective in improving appropriate intravenous placement in patients with GIH.
Identifiants
pubmed: 32433157
doi: 10.1097/NCQ.0000000000000448
pii: 00001786-202007000-00019
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E41-E46Références
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