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Avaliação do conhecimento dos enfermeiros em relação às catecolaminas de infusão contínua / Evaluation of nurses knowledge regarding to catecholamine of continuous infusionNishi, Fernanda Ayache 28 May 2007 (has links)
A administração de catecolaminas por via intravenosa é uma prática comum no ambiente hospitalar, principalmente em Unidade de Terapia Intensiva (UTI), Hemodiálise e Pronto Socorro (PS). Apesar de se tratar de um procedimento que demanda cuidados de enfermagem bastante específicos, este pode ser realizado por qualquer membro da equipe de enfermagem, até mesmo sem supervisão direta de um enfermeiro. Para prestar cuidados de enfermagem adequados aos pacientes que recebem catecolaminas por via intravenosa é necessário que o profissional que realiza o procedimento disponha de conhecimento específico acerca da prática realizada. Em unidades como UTI, PS e Hemodiálise, espera-se que o enfermeiro exerça supervisão direta desses cuidados, já que são unidades em que os pacientes apresentam condições mais críticas e geralmente instáveis. Desta forma, é esperado que o enfermeiro detenha todo o conhecimento necessário para administrar as catecolaminas com segurança, minimizando assim os riscos para o paciente. Estes conhecimentos devem ser aprofundados englobando desde ciências básicas como anatomia e fisiologia, até aspectos mais específicos como a escolha do cateter, recomendações de uso dos materiais disponíveis, conhecimentos farmacológicos direcionados e recomendações e cuidados durante a infusão desse tipo de medicamento. Este estudo avaliou o grau de conhecimento dos enfermeiros do Hospital Universitário (HU) da Universidade de São Paulo (USP) quanto à administração de catecolaminas de infusão contínua por via intravenosa. Foram sujeitos deste estudo somente os enfermeiros que atuam em unidades onde a administração de catecolaminas é prática comum. A pesquisa limitou-se aos enfermeiros que atuam em unidades de cuidados de adultos por considerar que há peculiaridades existentes no cuidado do paciente adulto e pediátrico no que diz respeito à administração de drogas vasoativas e à necessidade de atualização e vivência prática da situação. Assim, através de questionário estruturado, procedeu-se a avaliação do conhecimento dos enfermeiros atuantes nas unidades de Hemodiálise, PS de adultos e UTI de adultos com relação à administração de catecolaminas por via intravenosa. Os dados obtidos com a aplicação dos questionários foram submetidos a análises estatísticas para definir se o conhecimento apresentado pelos enfermeiros avaliados é condizente com o preconizado pela literatura para realização segura de tal procedimento / Catecholamine management through intravenous route is a common practice in the hospital setting, mainly at the Intensive Care Unit (ICU), Hemodialysis and Emergency Room (ER). Although it\'s a procedure that demands very specific nursing care, this can be made by any member of the nursing staff, even without direct supervision of a nurse. For delivering optimal nursing care to patients who receive catecholamine through intravenous route, it\'s necessary the provider who makes the procedure to have specific knowledge on this practice. In settings like ICU, ER and Hemodialysis, the nurse is expected to have direct supervision in these procedures, once they are units where patients present more critical and generally unstable conditions. This way, the nurse is supposed to have all the knowledge necessary to manage catecholamine safely, thus minimizing the risks for the patient. This knowledge must be deepen involving from basic sciences such as anatomy and physiology, to more specific aspects, such as the catheter chosen, recommendations for use of available material, specified pharmacological knowledge and recommendations and care during infusion of this type of medication. This study evaluated the knowledge level of nurses from University Hospital (HU) of University of Sao Paulo (USP) regarding to catecholamine management of continuous infusion through intravenous route. Subjects of the study were only the nurses who work in setting where catecholamine management is a common practice. The research limited to nurses who work in adult care, considering that there are peculiarities in adult and pediatric care related to vasoactive medication management and the need of upgrade and practical experience of the situation. Thus, through a structured questionnaire, it was made an evaluation of knowledge of nurses who work in Hemodialysis units, adult ER and adult ICU regarding to catecholamine management through intravenous route. The data obtained through the questionnaires were submitted to statistic analyses to define if the knowledge presented by the evaluated nurses is according to what is advised by literature to make safely such procedure
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The Effect of Dose Error Reduction Software on the Ability of Nurses to Safely and Efficiently Administer Intravenous MedicationsRothwell, Sarah 13 January 2010 (has links)
The purpose of this research was to compare the design of Dose Error Reduction Software (DERS) between smart pumps to determine which features affect the ability of nurses to safely and efficiently program intravenous medications. A high-fidelity usability experiment was conducted. Twenty-four Registered Nurses completed a series of infusion tasks, in a simulated clinical environment, using three smart pumps (Cardinal Alaris System, BBraun Infusomat, and Hospira Symbiq). Results found significant differences in nursing performance across the smart pumps. Nurses were more likely to override clinically inappropriate soft limit alerts when using BBraun Infusomat, than when using Hospira Symbiq or Cardinal Alaris System. Furthermore, when asked to program an infusion over a specific duration, nurses were found to make significantly more parameter entry errors when using Hospira Symbiq than when using Cardinal Alaris System. Results from this study will help set DERS design principles, and assist hospitals during their procurement processes.
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The Effect of Dose Error Reduction Software on the Ability of Nurses to Safely and Efficiently Administer Intravenous MedicationsRothwell, Sarah 13 January 2010 (has links)
The purpose of this research was to compare the design of Dose Error Reduction Software (DERS) between smart pumps to determine which features affect the ability of nurses to safely and efficiently program intravenous medications. A high-fidelity usability experiment was conducted. Twenty-four Registered Nurses completed a series of infusion tasks, in a simulated clinical environment, using three smart pumps (Cardinal Alaris System, BBraun Infusomat, and Hospira Symbiq). Results found significant differences in nursing performance across the smart pumps. Nurses were more likely to override clinically inappropriate soft limit alerts when using BBraun Infusomat, than when using Hospira Symbiq or Cardinal Alaris System. Furthermore, when asked to program an infusion over a specific duration, nurses were found to make significantly more parameter entry errors when using Hospira Symbiq than when using Cardinal Alaris System. Results from this study will help set DERS design principles, and assist hospitals during their procurement processes.
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Avaliação do conhecimento dos enfermeiros em relação às catecolaminas de infusão contínua / Evaluation of nurses knowledge regarding to catecholamine of continuous infusionFernanda Ayache Nishi 28 May 2007 (has links)
A administração de catecolaminas por via intravenosa é uma prática comum no ambiente hospitalar, principalmente em Unidade de Terapia Intensiva (UTI), Hemodiálise e Pronto Socorro (PS). Apesar de se tratar de um procedimento que demanda cuidados de enfermagem bastante específicos, este pode ser realizado por qualquer membro da equipe de enfermagem, até mesmo sem supervisão direta de um enfermeiro. Para prestar cuidados de enfermagem adequados aos pacientes que recebem catecolaminas por via intravenosa é necessário que o profissional que realiza o procedimento disponha de conhecimento específico acerca da prática realizada. Em unidades como UTI, PS e Hemodiálise, espera-se que o enfermeiro exerça supervisão direta desses cuidados, já que são unidades em que os pacientes apresentam condições mais críticas e geralmente instáveis. Desta forma, é esperado que o enfermeiro detenha todo o conhecimento necessário para administrar as catecolaminas com segurança, minimizando assim os riscos para o paciente. Estes conhecimentos devem ser aprofundados englobando desde ciências básicas como anatomia e fisiologia, até aspectos mais específicos como a escolha do cateter, recomendações de uso dos materiais disponíveis, conhecimentos farmacológicos direcionados e recomendações e cuidados durante a infusão desse tipo de medicamento. Este estudo avaliou o grau de conhecimento dos enfermeiros do Hospital Universitário (HU) da Universidade de São Paulo (USP) quanto à administração de catecolaminas de infusão contínua por via intravenosa. Foram sujeitos deste estudo somente os enfermeiros que atuam em unidades onde a administração de catecolaminas é prática comum. A pesquisa limitou-se aos enfermeiros que atuam em unidades de cuidados de adultos por considerar que há peculiaridades existentes no cuidado do paciente adulto e pediátrico no que diz respeito à administração de drogas vasoativas e à necessidade de atualização e vivência prática da situação. Assim, através de questionário estruturado, procedeu-se a avaliação do conhecimento dos enfermeiros atuantes nas unidades de Hemodiálise, PS de adultos e UTI de adultos com relação à administração de catecolaminas por via intravenosa. Os dados obtidos com a aplicação dos questionários foram submetidos a análises estatísticas para definir se o conhecimento apresentado pelos enfermeiros avaliados é condizente com o preconizado pela literatura para realização segura de tal procedimento / Catecholamine management through intravenous route is a common practice in the hospital setting, mainly at the Intensive Care Unit (ICU), Hemodialysis and Emergency Room (ER). Although it\'s a procedure that demands very specific nursing care, this can be made by any member of the nursing staff, even without direct supervision of a nurse. For delivering optimal nursing care to patients who receive catecholamine through intravenous route, it\'s necessary the provider who makes the procedure to have specific knowledge on this practice. In settings like ICU, ER and Hemodialysis, the nurse is expected to have direct supervision in these procedures, once they are units where patients present more critical and generally unstable conditions. This way, the nurse is supposed to have all the knowledge necessary to manage catecholamine safely, thus minimizing the risks for the patient. This knowledge must be deepen involving from basic sciences such as anatomy and physiology, to more specific aspects, such as the catheter chosen, recommendations for use of available material, specified pharmacological knowledge and recommendations and care during infusion of this type of medication. This study evaluated the knowledge level of nurses from University Hospital (HU) of University of Sao Paulo (USP) regarding to catecholamine management of continuous infusion through intravenous route. Subjects of the study were only the nurses who work in setting where catecholamine management is a common practice. The research limited to nurses who work in adult care, considering that there are peculiarities in adult and pediatric care related to vasoactive medication management and the need of upgrade and practical experience of the situation. Thus, through a structured questionnaire, it was made an evaluation of knowledge of nurses who work in Hemodialysis units, adult ER and adult ICU regarding to catecholamine management through intravenous route. The data obtained through the questionnaires were submitted to statistic analyses to define if the knowledge presented by the evaluated nurses is according to what is advised by literature to make safely such procedure
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Intravenous medication safety practices of registered nurses in neonatal and paediatric critical care areasCronje, Liza 03 1900 (has links)
Thesis (Mcur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: A literature study showed that the topics of medication safety and medication error prevention
have been studied in depth. Findings from the literature revealed that medication errors are
reported to be common in neonatal and paediatric ICUs, that more than half of these errors are
preventable and that risk reduction measures protect patients against untoward outcomes or
adverse events (Clifton-Koeppel, 2008:72). If and when there is a failure in the process of safe
medication administration, it results in a medication error, which is defined as a breach of one or
more of the five rights of medication administration (Institute for Safe Medication Practices Alert,
2007:1).
Medication administration, which is predominantly a nursing task, is of high risk and high volume
in the intensive care unit (ICU). The accuracy of intravenous medication administration is critical
for a neonatal and paediatric ICU patient since it can potentially heighten the patient’s
vulnerability if further harm is caused. In view of the complexity of medication administration for
neonatal and paediatric ICU patients, researchers confirm the diverse role of the registered
nurse in safe medication administration practices.
The purpose of the study was to describe the perceptions of registered nurses (RNs) regarding
the factors that influence IV medication safety practice in the neonatal intensive care unit
(NICU); paediatric intensive care unit (PICU); and paediatric cardiac intensive care unit (CSICU)
in Saudi Arabia. The study objectives were set to describe the actual factors that have an
influence on IV medication safety practices of RNs working in these ICUs; to determine the
knowledge of registered nurses in the selected ICUs with regard to safe intravenous medication
administration practices and to describe nursing medication administration strategies that are
focused on medication error prevention.
A quantitative research approach was selected for this study which had a descriptive, survey
design. An 85% non-probability purposive sampling method was used to draw a sample (n=103)
of the target population of NICU-, PICU- and CSICU-registered nurses (N=121) who were
responsible for administering intravenous medication at King Faisal Specialist Hospital and
Research Centre in Jeddah (KFSHRC-J). A self-administered questionnaire with closed-ended Likert and open-ended question was
designed to describe the objectives under study. A pilot study was conducted to pre-test the
questionnaire. A quantitative method was used to analyse the study data. MS Excel was used
to capture the quantitative data after which it was analysed using descriptive statistics by means
of STATISTICA 9 software. The open–ended questions (indicating “other” and Question 70)
were also interpreted quantitatively after exploring the main aspects in the responses. The main
findings were that multiple perceived factors influence the intravenous medication safety
practices of RN’s working with neonatal and paediatric ICU patients in a particular Saudi
Arabian tertiary hospital. It was found that these nurses’ had knowledge regarding safe
medication administration practice that constitutes that all five medication rights have to be
checked through nursing ‘double-checks’ in the steps of medication administration, as the
method of checking as per hospital policy. However, from the findings, it is reflected that RNs
perceptions of completely and correctly checking medication rights through complete and
independent nursing ‘double-checks’, do not match the steps required by policy and that their
knowledge is inadequate. It is evident from the perceptions of RNs that they are aware of the
multiple factors influencing IV medication safety practice in this vulnerable patient setting. As
perceived by RNs, it is possible to implement more safety strategies. Key recommendations on
conclusion of the study include that there are more nursing medication administration strategies
that could still be implemented for medication error prevention. These strategies relate to
medication safety awareness, the role of the nurse and nursing managers, mandatory staff
education, and review of knowledge and skills. / AFRIKAANSE OPSOMMING: Gebaseer op ʼn literatuurstudie blyk dit dat medikasieveiligheid en voorkoming van
medikasiefoute reeds in diepte bestudeer are. Bevindings dui daarop dat medikasiefoute
algemeen voorkom in neonatale en pediatriese intensiewesorgeenhede, dat meer as die helfte
daarvan voorkombaar is, en dat maatreëls om risiko te vermindering pasiënte teen
voorkombare uitkomste beskerm (Clifton-Koeppel, 2008:72). Indien en wanneer die proses vir
veilige medikasietoediening faal, kom ʼn medikasiefout voor, wat gedefinieer word as die
verbreking van een of meer van die vyf medikasieregte (Institute for Safe Medication Practices
Alert, 2007:1).
Medikasietoediening is hoofsaaklik ʼn verpleegtaak, wat ʼn hoërisiko- en hoëvolume-taak behels.
Die akkuraatheid van intraveneuse medikasietoediening is kritiek vir neonatale en pediatriese
intensiewesorgpasiënte, aangesien hul weerloosheid verhoog word indien verdere skade
veroorsaak word. Omrede medikasietoediening vir neonatale en pediatriese
intensiewesorgpasiënte kompleks is, bevestig navorsers dat geregistreerde verpleegkundiges
se rol ten opsigte van veilige medikasietoediening veelsoortig is.
Die doel van die studie was om die persepsies van geregistreerde verpleegkundiges
aangaande die faktore wat medikasieveiligheid in die neonatale en paediatriese intensiewe
eenhede in Saoedi-Arabië beinvloed, te beskryf. Studiedoelwitte is gestel om die spesifieke
faktore te beskryf wat aanleiding gee tot medikasietoedieningsfoute in die genoemde
intensiewesorgeenhede; om geregistreerde verpleegkundiges in die geselekteerde
intensiewesorgeenhede se kennis van veilige medikasietoediening te bepaal; en die
medikasietoedieningstrategieë wat op die voorkoming van medikasietoedieningsfoute fokus, te
beskryf.
ʼn Kwantitatiewe navorsingsbenadering is geselekteer vir die studie wat ʼn beskrywende
navorsingsontwerp gehad het. ʼn 85% nie-waarskynlike gerieflikheidsteekproef is gebruik om ʼn
steekproef (n=103) te selekteer vanuit die teikenpopulasie geregistreerde verpleegkundiges
(N=121) wat verantwoordelik was vir medikasietoediening in die geselekteerde
intensiewesorgeenhede by King Faisal Specialist Hospital and Research Centre, Jeddah
(KFSHRC-J). ʼn Self-geadministreerde vraelys met geslote Likert- en oop-eindevrae is opgestel om die
gestelde studiedoelwitte te ondersoek. ʼn Vooraf-toetsing van die vraelys is tydens die
loodsstudie uitgevoer. ʼn Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik vir
die ontleding van die studie-data. Die kwantitatiewe data is op MS Excel ingevoer, waarna
beskrywende statistiek deur middel van Statistica 9-sagteware gebruik is om dit te ontleed. Die
studie het hoofsaaklik bevind dat veelvuldige faktore die veiligheidspraktyk ten opsigte van
intraveneuse medikasie van geregistreerde verpleegkundiges wat met neonatal en pediatriese
intensiewesorgpasiënte in ʼn spesifieke tersiêre hospitaal in Saoedi-Arabië werk, beïnvloed. Dit
blyk dat hierdie verpleegkundiges se kennis voldoende is aangaande ‘n veilige medikasie
toedieningspraktyk wat bestaan uit die kontrolering van al vyf medikasieregte deur
verpleegkundige dubbel-kontrolering, soos beskryf is in die hospitaalbeleid. Volgens die
bevindinge blyk dit egter dat die verpleegkundiges se persepsie van volledige and korrekte
verpleegkundige dubbel-kontrolering, nie met die stappe volgens die hospitaalbeleid
ooreenstem nie en dat hulle kennis onvoldoende is. Dit is duidelik dat die verpleegkundiges
bewus is van die veelvuldige faktore wat intraveneuse medikasieveiligheidpraktyk vir weerlose
pasiënte beïnvloed. Die verpleegkundiges se persepsie is dat daar meer verpleegkundige
medikasietoedieningstrategieë is wat geïmplementeer kan word om medikasiefoute te voorkom,
insluitende veiligheidsbewustheid ten opsigte van medikasie, die rol van verpleegkundiges en
verpleegbestuurders, verpligte personeelopleiding, en hersiening van kennis en vaardighede.
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A Healthcare Failure Mode and Effect Analysis on the Safety of Secondary InfusionsYue, Ying Kwan 27 November 2012 (has links)
Secondary infusions are a common and convenient method to administer intermittent infusions unattended through a single IV access using infusion pump technology. Previous studies have indicated that clinicians have a high frequency of committing operation errors while administering secondary infusions, which can cause patient harm. The purpose of this study was to evaluate the safety of secondary infusion practice by identifying and analyzing potential failure modes when delivering secondary infusions on five different smart infusion pumps. Healthcare Failure Mode and Effect Analysis (HFMEA) was used to prioritize potential failure modes that are considered high-risk for each pump. Results showed that four of the five pumps were not able to mitigate physical set-up errors. As well, each pump contributed differently to programming errors due to difference in interface design. Recommendations from this study focused on outlining desired infusion pump features and mitigation strategies to help alleviate high-risk secondary infusion failure modes.
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A Healthcare Failure Mode and Effect Analysis on the Safety of Secondary InfusionsYue, Ying Kwan 27 November 2012 (has links)
Secondary infusions are a common and convenient method to administer intermittent infusions unattended through a single IV access using infusion pump technology. Previous studies have indicated that clinicians have a high frequency of committing operation errors while administering secondary infusions, which can cause patient harm. The purpose of this study was to evaluate the safety of secondary infusion practice by identifying and analyzing potential failure modes when delivering secondary infusions on five different smart infusion pumps. Healthcare Failure Mode and Effect Analysis (HFMEA) was used to prioritize potential failure modes that are considered high-risk for each pump. Results showed that four of the five pumps were not able to mitigate physical set-up errors. As well, each pump contributed differently to programming errors due to difference in interface design. Recommendations from this study focused on outlining desired infusion pump features and mitigation strategies to help alleviate high-risk secondary infusion failure modes.
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Mitigating Risks Associated with Secondary Intravenous Infusions: An Empirical Evaluation of a Technology-based, Training-based, and Practice-based InterventionChan, Katherine Yin-Yee 21 November 2013 (has links)
Secondary infusions is a common method to deliver short infusions of intravenous (IV) drugs and fluids. Errors associated with this infusion method have led to patient safety concerns. This study's objective was to empirically evaluate interventions to mitigate secondary infusion risks. Three interventions, including a technology-based intervention (clamp detector on a smart pump), a training-based intervention (educational module), and a practice-based intervention (use of a separate pump for short infusions), were tested in a simulated inpatient unit. The technology-based intervention significantly decreased secondary clamp errors whereas the training-based intervention reduced complex pressure differential errors. The practice-based intervention was the only intervention that significantly decreased both secondary clamp errors and pressure differential errors, but introduced new risks due to mismanagement of residual volume in IV tubing. Study results highlight the need for a combination of mitigation strategies and can help guide the selection of interventions to reduce secondary infusion errors.
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Mitigating Risks Associated with Secondary Intravenous Infusions: An Empirical Evaluation of a Technology-based, Training-based, and Practice-based InterventionChan, Katherine Yin-Yee 21 November 2013 (has links)
Secondary infusions is a common method to deliver short infusions of intravenous (IV) drugs and fluids. Errors associated with this infusion method have led to patient safety concerns. This study's objective was to empirically evaluate interventions to mitigate secondary infusion risks. Three interventions, including a technology-based intervention (clamp detector on a smart pump), a training-based intervention (educational module), and a practice-based intervention (use of a separate pump for short infusions), were tested in a simulated inpatient unit. The technology-based intervention significantly decreased secondary clamp errors whereas the training-based intervention reduced complex pressure differential errors. The practice-based intervention was the only intervention that significantly decreased both secondary clamp errors and pressure differential errors, but introduced new risks due to mismanagement of residual volume in IV tubing. Study results highlight the need for a combination of mitigation strategies and can help guide the selection of interventions to reduce secondary infusion errors.
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