Quality Improvement Project: Educating Nurses on Vasopressors through Peripheral Intravenous Access
Abstract
ABSTRACT
Hemodynamic instability and hypoperfusion to organs are significant features of shock. Vasopressors are a life saving medication used for patients in shock. For many years, vasopressor infusions through peripheral intravenous access (PIV) have been considered high risk for extravasation with tissue injury. In recent years, researchers have shown vasopressor infusions through PIV access can be administered safely. This new development is especially important for hospitals with barriers to emergent central venous access (CVC). Currently, there are no best practice guidelines for nurses to follow regarding infusion of vasopressor medications through PIV access. A retrospective chart review over a one-year time period prior to an education secession and for one month following the education session were performed to determine the frequency of vasopressor medication infusions through PIVs. An education session was provided to ICU and ED nurses to educate them on the importance of timely administration of vasopressor medications, as well as, how to mitigate the risk of extravasation through a PIV. Surveys were used to evaluate knowledge and confidence pre, post, and one-month-post education session. The results of the knowledge survey showed a statistically significant improvement in nurses' knowledge both immediately following the education session and one-month following. The results of the confidence survey showed a statistically significant improvement in nurses' confidence from the pre-confidence survey to the immediate post-confidence survey and from the pre-confidence survey to the one-month follow up survey. However, there was no statistical significance from the immediate post-survey to the one-month follow up confidence survey.
Hemodynamic instability and hypoperfusion to organs are significant features of shock. Vasopressors are a life saving medication used for patients in shock. For many years, vasopressor infusions through peripheral intravenous access (PIV) have been considered high risk for extravasation with tissue injury. In recent years, researchers have shown vasopressor infusions through PIV access can be administered safely. This new development is especially important for hospitals with barriers to emergent central venous access (CVC). Currently, there are no best practice guidelines for nurses to follow regarding infusion of vasopressor medications through PIV access. A retrospective chart review over a one-year time period prior to an education secession and for one month following the education session were performed to determine the frequency of vasopressor medication infusions through PIVs. An education session was provided to ICU and ED nurses to educate them on the importance of timely administration of vasopressor medications, as well as, how to mitigate the risk of extravasation through a PIV. Surveys were used to evaluate knowledge and confidence pre, post, and one-month-post education session. The results of the knowledge survey showed a statistically significant improvement in nurses' knowledge both immediately following the education session and one-month following. The results of the confidence survey showed a statistically significant improvement in nurses' confidence from the pre-confidence survey to the immediate post-confidence survey and from the pre-confidence survey to the one-month follow up survey. However, there was no statistical significance from the immediate post-survey to the one-month follow up confidence survey.