Aim: To determine the compliance with nursing drug administration procedure steps associated with access to the central venous catheter for bolus infusion in intensive care units. Methods: This observational study was conducted with 30 nurses working in an intensive care unit of a university hospital. The drug administrations practiced by nurses via central venous catheter were monitored simultaneously at 12:00 a.m., 02:00 p.m., and 06:00 p.m. by two observers. The data were collected using a data collection form and central venous catheter drug administration procedure steps. Results: A total of 90 different drug administrations were observed in three different treatment hours from 30 nurses. The interobserver conformity was found to be moderate in two steps (kappa = 0.520–0.627, P = 0.01) and perfect in all other steps (kappa = 0.821–1.000, P = 0.000). According to the drug administration procedure steps via a central venous catheter, all nurses applied the following steps correctly during all treatment hours: drug card control, preparation of treatment materials, checking the patient’s identity, and steps of drug treatment administration. The following tasks were frequently performed incorrectly or not at all: hand hygiene (before treatment 87.8%; after treatment 82.2%), scrubbing the three-way stopcock entrance with an alcohol swab (55.6%), waiting for the alcohol to dry (81.1%), and flushing the lumen with a compatible fluid (before treatment 84.4%: after treatment 75.6%). Conclusion: Observation of drug administration procedure steps via central venous catheter according to the treatment hours showed that the nurses performed many incomplete or inaccurate drug administration procedure steps and the mistakes increased toward the evening hours.
Background
Patient positioning is an independent nursing intervention and may increase peripheral oxygenation for patients with lung disease. Few studies have been conducted on the effect of body positions on oxygenation in patients with lung disease.
Aims and objectives
To investigate the effects of five different positions on peripheral oxygen saturation (SpO2) and vital signs in patients with lung disease.
Design
A semi‐experimental study was conducted.
Methods
Consecutive samples were recorded from critical care patients followed in the chest clinic of a university hospital. A total of 109 patients with lung disease were recruited. Patients who were able to lie in all positions, and who had unilateral or bilateral lung disease documented by a medical diagnosis by a physician were included in this study. The SpO2 and vital signs were measured at each position three times.
Results
For patients with right, left, and bilateral lung disease, lying on the right side of the body at 45 in bed, the SpO2 was higher, but this difference was not statistically significant. There was a significant difference at 40 minutes between the pulse rate in patients with left and bilateral lung disease, but not in patients with right lung disease. No significant differences were found between respiratory rates and body temperature in patients in any of the three groups at 10, 25, and 40 minutes.
Conclusions
Although this difference was not statistically significant, lying on the right side of the body at 45 in bed can be an effective position for improving oxygenation in all patients with lung disease.
Relevance to Clinical Practice
As there is insufficient evidence to suggest a specific position, further studies are needed. This study provides evidence that the best oxygenation in patients with unilateral and bilateral lung disease can be obtained by determining the appropriate position for critical care nurses.
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