IV Catheter: A Case Study

The work of Burke, et al (2011) reports that a study with the objective of comparing the "efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization." (p.1) The study concluded that intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment." (Burke, et al, 2011, p.1) Burke et al reports that surgery is something that most people fear with the fear of the unknown is combined with "apprehension about such anticipated procedures as insertion of an IV line." (2011, p.1) Burke additionally reports that patients admitted for same-day surgery "require IV access. Any venipuncture, including peripheral IV catheterization with a medium-to-large-gauge catheter, can cause some degree of pain. Using local anesthesia prior to IV catheterization has

Getting an infection from improper care during or after insertion of a central line is the last thing you want to get while in the hospital. This paper will discuss Kaiser Permanente’s policy on central venous catheter, also known as a central line, care and dressing change, and whether it follows the current evidence-based practice on preventing bloodstream infection in patients who have them inserted. I will explain about what a central line is, why evidence-based practice is important in the clinical setting, what Kaiser Permanente’s policy about central line care and dressing change is, if Kaiser is currently following evidence-based practice based on current articles about preventing central line associated bloodstream infections (CLABSIs), and what my role in using evidence-based practice is as a future registered nurse.

The purpose of this paper is to present an analysis of a quantitative article using Melnyk & Fineout-Overholt’s (2015) rapid critical appraisal (RCA) for a randomized clinical trial. Topics included are the validity of the research, results of the research and how the information can be applied to the clinical care of my own patient population.

While this structure provides a starting point for the critique of evidence strength, the prudent evaluation and, subsequent, translation into practice guidelines requires further consideration (Greenhalgh, 2010). Research can be scrutinized into measures of quality. John Hopkins Hospital grades evidence on a high to low scale, A through C, based on criteria including consistency of results, reproducibility of findings, sample size of study, level of study control, organizational design, and expert opinion (Newhouse, Dearholt, Poe, Pugh, & White, 2005). Using this evaluation tool, an A score would result in a recommendation for clinical practice while a score of C should alert the clinician to a low quality of research and should not be incorporated into practice guidelines (Newhouse et al., 2005).

Evidence based practice is the incorporation of individual clinical expertise with best research evidence and patient values and expectations. Health care decision of individual patients should be based on best available research evidence. A health decision made from a sound research evidence has the potential to ensure best practice and reduce variations in health care delivery. In health science, an ever increasing plethora of studies being published and is challenging for clinicians to keep up with the literature. Integrating research into practice is time consuming and need methods for easy access to such evidences for busy clinicians. Indeed, clinical decision should be based on the latest research evidence. Systematic reviews and meta-analyses summarize the research evidence, which is generally the best form of evidence, thereby making the available evidence more accessible to decision makers and are positioned

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

. The organization’s culture patients are found using indwelling catheterization for long periods of time, and no protocol for removal of the catheter post-operative patient’s, and also unnecessary Foley insertion on elderly inpatients for incontinence. Simultaneously, it is important to note that by avoiding indwelling cauterization and prolonged stay of catheter in patients may increase the infection and (CAUTIs (Bernard, Hunter, & Moore, (2012). The author made a survey and then analyzed it as a whole. However, the survey documented low and high score related to the case.

Case reports have an antidotal contribution to clinical evidence. Case reports are beneficial in that they require little clinical education to appreciate and can quickly disseminate information without the tedious process of clinical research (Greenhalgh, 2010). The benefits of case reports are overshadowed by their drawbacks. Due to the lack of scientific process and control, case reports are considered low quality evidence (Greenhalgh, 2010).

In researching the question, “In hospitalized adults, how does routine, compared with clinically indicated replacement of peripheral IV catheters affect patients?” the article: Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: A randomized study (Lopez et al., 2014) provides a randomized study that examined not only the research question of patient complications, but of the clinical cost of adhering to a regime of replacing all peripheral IV catheters (PIVC) after less than 96 hours (regardless of patency or patient’s expected time until discharge), versus replacing PIVCs as needed. (Lopez et al., 2014)

Peripheral IV catheterization is a painful and potentially anxiety-provoking procedure for the patients. The interventions to reduce the pain caused by venipuncture were explored in the past decades (Oman, 2014). The majority of the studies reviewed in this summary included one level 1 evidence of meta-analyses (Oman, 2014), three level 2 evidences of randomized controlled trials (Beck, 2011; Deguzman, 2012; Kahre, 2011) and one level 3 evidence of controlled trials without randomization (Levitt , 2013). Many studies have demonstrated that 1% lidocaine intradermal injection before IV insertion can reduce the pain significantly (Oman, 2014). Kahre and his colleagues’ study indicated bacteriostatic normal saline (BNS) group had lower pain score

According to Steven (2013), evidence-based practice bestowed the practicing frontline nurses with superlative knowledge of data, lessen variances in practice, and foster an effective, efficient interference and decision-making capability. Nicolle (2010) indicated that the main evidence-based theoretical alteration related to urinary catheter usage recommendation is to curtail essentially the introduction and the length of usage as you indicated in your post.

There has been a reoccurring incidence of staff members using urinary indwelling catheters for unnecessary reasons and convenience. More so, the nurses did not think of the issue as the most

The four accepted articles were analyzed and summarized. Article validity, reliability, and bias are included in the discussion. An overview of the articles are included in Table 2, indicating evidence level, design, population characteristics, intervention specifics, outcome measures, and PICO question relevance.

Some of this study’s findings require elaboration and some aspects could be reconsidered in future studies. As a first major limitation, the sample size must be addressed. Small samples are a common and mostly unavoidably drawback in clinical research (Bacchetti, Wolf, Segal, & McCulloch, 2005). On the one hand research on small clinical populations might be warranted, for example, for the study of unique study populations or a rare disorder. On the other hand the number of participants was rather small concerning the applied statistical methods. Therefore, we calculated effect sizes to guide our interpretations, as examining effects using small sample sizes, significance testing can be misleading. Moreover, no simple answer exists to the question

The use of intravenous therapy in the hospitals is now considered a routine therapy. In 2016, DeVries and Valentine stated that 70% to 80% of hospital patients have peripheral intravenous lines at some time during their stay. A peripheral intravenous (PIV) line is a small hollow tube (catheter) that is inserted into a vein and can be connected to special tubing. PIV line is commonly used to administer medications or fluids directly into the vein. The article “Intravenous Therapy: A Review of Complications and Economic Considerations of Peripheral Access,” states that the history of intravenous (IV) therapy dates back to the Middle Ages. Dr. Thomas Latta pioneered the use of IV saline infusion during the cholera epidemic and in the 20th century, two world wars established a role for IV therapy as routine medical practice (Dychter, Gold, Carson, & Haller, 2012).