The research agenda for protocol-based care

Rycroft‐Malone, Jo; Morrell, Clare; Bick, Debra

doi:10.7748/ns2004.10.19.6.33.c3730

Cited by 11 publications

(6 citation statements)

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“…Success depends on the characteristics of the object of implementation and the context, as well as the individuals and activities involved [4,8]. The implementation process of CPs is seldom illuminated, the knowledge about the mechanisms through which CPs work remains insufficient and there is need of further knowledge from different contexts regarding the phenomenon [4,6,9–11].…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the implementation process of clinical pathways: a mixed method study within the context of Swedish intensive care

Bjurling-Sjöberg

Wadensten

Pöder

et al. 2015

Evaluation Clinical Practice

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Bottom-up initiatives, interprofessional project groups and small ICUs seem to enhance successful implementation of CPs while inadequate electronic health record systems, insufficient support and time constrains can be barriers. Support regarding the whole implementation process from centralized units at the local hospitals, as well as cooperation between ICUs and national guidance, has the potential to raise the quality of CPs and benefit the progress of CP implementation.

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Section: Introductionmentioning

confidence: 99%

Factors affecting the implementation process of clinical pathways: a mixed method study within the context of Swedish intensive care

Bjurling-Sjöberg

Wadensten

Pöder

et al. 2015

Evaluation Clinical Practice

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“…Patient outcomes, reduced length of stay and reduction of complications are used to determine the effectiveness of the standardization of care. [9] A review of the literature yielded few studies that implemented a nurse-driven protocol for administration of vasopressors through PIV access. A retrospective chart review of vasopressor administration through a PIV catheter demonstrated a 4% overall incidence of extravasation events when a strict safety protocol was not in place.…”

Section: Review Of the Literaturementioning

confidence: 99%

The development of a nurse-driven protocol for the safe administration of vasopressors through peripheral intravenous catheters

Padrone

Galiczewski

Amitrano

et al. 2018

IJH

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Aim: The purpose of this quality improvement project was to develop a nurse-driven protocol to provide a safer, quicker, and less complication-prone alternative for the administration of vasopressors. Background: The use of vasopressor medication is a common life saving intervention used to achieve hemodynamic stability in critically ill patients. Vasopressor infusions are routinely administered through central venous catheters (CVC) for fear that extravasation into subcutaneous tissue will result in ischemic injury. There are many potential complications of obtaining central venous access for vasopressor use, including pneumothoraces, arterial punctures and hematomas. Design: Quality improvement project. Methods: An interdisciplinary team developed a written protocol for the administration of vasopressors through peripheral intravenous (PIV) catheters based on the available scientific evidence. Key components of this quality improvement project were patient safety, a team approach and skilled monitoring of the infusion site. Critical care nurses were responsible for the line insertion, maintenance and identification of possible extravasation. All catheters placed were confirmed by ultrasonography and if extravasation of medication was suspected, the extravasation protocol was followed without delay. Results: The protocol developed was utilized in a study by Cardenas-Garcia et al. (2015). Extravasation occurred in 19 of 734 patients (2%) without any tissue injury following the use of the extravasation protocol. This evidence-based protocol for peripherally administered vasopressors decreased central line use and the potential complications from the placement of CVCs. Strict adherence to this evidence-based nurse-driven protocol was essential for the safe administration of vasopressors via PIV access. Conclusion/Clinical relevance: Peripheral administration of vasopressors has many beneficial implications for nursing practice. A nurse-driven protocol for peripheral vasopressors can eliminate the need for CVCs, which will reduce the incidence of central line-associated blood stream infections and decrease the number of central line days. This also may eliminate potential complications from CVC placement. Lastly, peripherally administered vasopressors may prevent a delay in treatment often experienced with placement of a central line.

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“…SCPs may also help staff improve patient outcomes, reduce length of hospital stays, and enhance teamwork and record keeping (Rycroft‐Malone et al . , Deneckere et al . , Deng et al .…”

Section: Introductionmentioning

confidence: 99%

Standardised care plans for in hospital stroke care improve documentation of health care assessments

Pöder

Dahm

Karlsson

et al. 2015

Journal of Clinical Nursing

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The research agenda for protocol-based care

Abstract: Protocols provide great potential to deliver best practice. However, questions remain about the benefits of protocol-based care.

Cited by 11 publications

References 0 publications

Factors affecting the implementation process of clinical pathways: a mixed method study within the context of Swedish intensive care

Factors affecting the implementation process of clinical pathways: a mixed method study within the context of Swedish intensive care

The development of a nurse-driven protocol for the safe administration of vasopressors through peripheral intravenous catheters

Standardised care plans for in hospital stroke care improve documentation of health care assessments

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