The Need for Manual Skills in an Automated World to Obtain Timely Blood Pressures in Trauma Patients.
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:
pubmed:
9
1
2021
medline:
21
9
2021
entrez:
8
1
2021
Statut:
ppublish
Résumé
Obtaining the first blood pressure (BP) during adult trauma team activations was often delayed. A review of patient charts revealed that the average time to first documented BP was 6.6 minutes when using an automatic BP cuff. The purpose was to determine whether taking the initial BP using a manual cuff decreases the time it takes to obtain the first BP. The Iowa Model Revised was used as the framework for this project. An algorithm was developed, and staff were educated and validated on their ability to obtain manual BPs. A 2-month practice change pilot was launched on adult full and partial trauma team activations. It was determined that taking a BP manually during adult trauma resuscitations was more efficient, allowing for earlier determination of patient status. Obtaining the initial BP manually was 54% more timely and led to an evidence-based practice change.
Sections du résumé
BACKGROUND
BACKGROUND
Obtaining the first blood pressure (BP) during adult trauma team activations was often delayed. A review of patient charts revealed that the average time to first documented BP was 6.6 minutes when using an automatic BP cuff.
PURPOSE
OBJECTIVE
The purpose was to determine whether taking the initial BP using a manual cuff decreases the time it takes to obtain the first BP.
METHOD
METHODS
The Iowa Model Revised was used as the framework for this project.
INTERVENTION
METHODS
An algorithm was developed, and staff were educated and validated on their ability to obtain manual BPs. A 2-month practice change pilot was launched on adult full and partial trauma team activations.
RESULTS
RESULTS
It was determined that taking a BP manually during adult trauma resuscitations was more efficient, allowing for earlier determination of patient status.
CONCLUSION
CONCLUSIONS
Obtaining the initial BP manually was 54% more timely and led to an evidence-based practice change.
Identifiants
pubmed: 33416263
doi: 10.1097/NCQ.0000000000000539
pii: 00001786-202110000-00010
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
346-349Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Kuo SC, Kuo PJ, Hsu SY, et al. The use of the reverse shock index to identify high-risk trauma patients in addition to the criteria for trauma team activation: a cross-sectional study based on a trauma registry system. BMJ Open. 2016;6(6):e011072. doi:10.1136/bmjopen-2016-011072
American College of Surgeons. Resources for Optimal Care of the Injured Patient. American College of Surgeons, Committee on Trauma; 2014.
Sanford Health. (2020). Sanford USD Medical Center. https://www.sanfordhealth.org/locations/sanford-usd-medical-center
Skirton H, Chamberlain W, Lawson C, Ryan H, Young E. A systematic review of variability and reliability of manual and automated blood pressure readings. J Clin Nurs. 2011;20(5/6):602–614. doi:10.1111/j.1365-2702.2010.03528.x
Davis JW, Davis IC, Bennink LD, Bilello JF, Kaups KL, Parks SN. Are automated BP measurements accurate in trauma patients? J Trauma. 2003;55(5):860–863. doi:10.1097/01.TA.0000092686.91877.de
Mansoor K, Shahnawaz S, Rasool M, Chaudhry H, Ahuja G, Shahnawaz S. Automated versus manual blood pressure measurement: a randomized crossover trial in the emergency department of a tertiary care hospital in Karachi, Pakistan: are third world countries ready for the change? Open Access Maced J Med Sci. 2016;4(3):404–409. doi:10.3889/oamjms.2016.076
Damme CD, Luo J, Buesing KL. Isolated prehospital hypotension correlates with injury severity and outcomes in patients with trauma. Trauma Surg Acute Care Open. 2016;1(1):e000013. doi:10.1136/tsaco-2016-000013
Carrick MM, Leonard J, Slone DS, Mains CW, Bar-Or D. Hypotensive resuscitation among trauma patients. Biomed Res Int. 2016;2016:8901938. doi:10.1155/2016/8901938
Moore FA, McKinley BA, Moore EE, et al. Inflammation and the host response to injury, a large-scale collaborative project: patient-oriented research core-standard operating procedures for clinical care: III. Guidelines for shock resuscitation. J Trauma. 2006;61(1):82–89. doi:10.1097/01.ta.0000225933.08478.65
Hanrahan K, Fowler C, McCarthy AM. Iowa Model Revised: research and evidence-based practice application. J Ped Nurs. 2019;48:121–122. doi:10.1016/j.pedn.2019.04.023