Protocol‐based care: impact on roles and service delivery*

Rycroft‐Malone, Jo; Fontenla, Marina; Bick, Debra; Seers, Kate

doi:10.1111/j.1365-2753.2008.01015.x

Cited by 59 publications

(68 citation statements)

References 17 publications

(18 reference statements)

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“…[5] Standardization of health care and the use of protocol-based care minimizes complications and positively affects delivery of care. [6,7] Protocols are developed by interdisciplinary healthcare teams and are based on review of the scientific evidence. [8] Measuring protocol-based care is often difficult.…”

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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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

View full text Add to dashboard Cite

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“…Protocol-based care is seen as a mechanism to facilitate professional nursing practice and to standardize care provided (13) . In this sense, it should be emphasized that the panorama presented by non-participants in the SOPs training reflects the importance of post-implantation evaluation.…”

Section: Discussionmentioning

confidence: 99%

Standard Operational Protocols in professional nursing practice: use, weaknesses and potentialities

et al. 2018

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Objective: to evaluate the use of Standard Operational Protocols (SOPs) in the professional practice of the nursing team based on the theoretical framework of Donabedian, as well as to identify the weaknesses and potentialities from its implementation. Method: Evaluative research, with quantitative approach performed with nursing professionals working in the Health Units of a city of São Paulo, composed of two stages: document analysis and subsequent application of a questionnaire to nursing professionals. Results: A total of 247 nursing professionals participated and reported changes in the way the interventions were performed. The main weaknesses were the small number of professionals, inadequate physical structure and lack of materials. Among the potentialities were: the standardization of materials and concern of the manager and professional related to patient safety. Conclusion: The reassessment of SOPs is necessary, as well as the adoption of a strategy of permanent education of professionals aiming at improving the quality of care provided. Descriptors: Quality of Health Care; Clinical Protocols; Nursing; Quality management; Quality Assurance of Health Care. RESUMO Objetivo: avaliar a utilização dos Procedimentos Operacionais Padrão (POP) na prática profi ssional da equipe de enfermagem, com base no referencial teórico de Donabedian, bem como identifi car as fragilidades e potencialidades a partir da sua implantação. Método: Pesquisa avaliativa, com abordagem quantitativa realizada com profi ssionais de enfermagem atuantes nas Unidades de Saúde de um município paulista, composta por duas etapas: análise documental e posterior aplicação de questionário aos profi ssionais de enfermagem. Resultados: Participaram 247 profi ssionais de enfermagem que referiram mudanças na forma de execução das intervenções estudadas. As principais fragilidades apontaram para o número reduzido de profi ssionais, inadequação da estrutura física e ausência de materiais. Entre as potencialidades destacaram-se: a padronização dos materiais e a preocupação do gestor e do profi ssional relacionada à segurança do paciente. Conclusão: A reavaliação dos POP é necessária, bem como a adoção da estratégia de educação permanente dos profi ssionais visando à melhoria da qualidade da assistência prestada. Descritores: Qualidade da Assistência à Saúde; Protocolos Clínicos; Enfermagem; Gestão da Qualidade; Garantia da Qualidade dos Cuidados de Saúde. RESUMEN Objetivo: Evaluar la utilización de los Procedimientos Operacionales Patrón (POP) en la práctica profesional del equipo de enfermería, con base en el referencial teórico de Donabedian, bien como identifi car las fragilidades y potencialidades a partir de su implantación. Método: Pesquisa evaluativa, con abordaje cuantitativa realizada con profesionales de enfermería actuantes en las Unidades de Salud Rev Bras Enferm [Internet]. 2018;71(1):126-34.

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“…Wissenschaftliche Ergebnisse müssen demnach in die p egerischen Handlungen ein ießen. Die systematische Anwendung von Forschungsergebnissen in der Praxis im Sinne von Evidence-based Nursing wird explizit mit der Qualität der P ege, als Rechtfertigungsgrundlage für P egende oder als gesetzliche Bedingung in Beziehung gesetzt (Milner et al, 2006;Sidani et al, 2006;Bundesgesetz über Gesundheits-und Krankenpflegeberufe, 2008;Schubert, Wrobel, 2008;Rycroft-Malone et al, 2008;Strickland, O´Leary-Kelley, 2009, Behrens, Langer, 2010 (Estabrooks et al, 2007;Strickland, O'Leary-Kelley, 2009;Haslinger-Baumann et al, 2014). Wenig Rollentransparenz und geringe De nition von Zuständigkeiten der verschiedenen P egepersonen in unterschiedlichen Managementfunktionen (Milner et al, 2006;Wilkinson et al, 2011), wie P egeberater, P egeexperten, Forschungsbeauftragte etc.…”

Section: Praxis In Krankenhäuser In öSterreichunclassified

Eine junge Disziplin

Haslinger-Baumann¹

2015

ProCare

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Protocol‐based care: impact on roles and service delivery*

Cited by 59 publications

References 17 publications

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

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

Standard Operational Protocols in professional nursing practice: use, weaknesses and potentialities

Eine junge Disziplin

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