What is the evidence based standard of care for patient monitoring during intravenous immunoglobulin infusion?

Posted on September 10, 2021 by John

“Due to the infrequent use of I.V. immune globulin (IVIG) in the oncology population, most nurses have little experience with IVIG administration. Multiple-step calculations are often required to administer IVIG based on patient weight. The cost of a single dose of IVIG can be very high, depending on the formulation. Consequently, administering IVIG can be stressful for nurses. This project has important patient safety implications. It highlights apprehension and distress surrounding IVIG administration and can be used as a guide to identify other areas of opportunity to improve nurse comfort and confidence with high adverse reaction profile medications.”

Barnum, T., Bohnenkamp, C., & Haas, S. (2017). A nursing protocol for safe IVIG administration. Nursing.,47(8), 15-19.
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What are some current fall prevention interventions for hospitalized patients?

Posted on August 31, 2021 by John

“Despite decades of fall prevention efforts, patient falls remain a common cause of harm in hospitalized older adults. While fall prevention strategies have been historically championed by nurses, hospitalist physicians, nurse practitioners, and physician assistants play a vital role in the multidisciplinary care team in ensuring the safety of our patients. Promising strategies for fall prevention include tailoring interventions to patient risk factors and individualized patient education. In addition to nursing-based interventions, the hospitalist’s role in fall prevention is to (1) identify and address potentially modifiable risk factors, (2) reinforce individualized education to patients, and (3) advise behavior choices that promote safe mobility.”

Keuseman, R., & Miller, D. (2020). A hospitalist’s role in preventing patient falls. Hospital Practice : Advances in Medicine for Primary Care Physicians.,48(Sup1), 63-67.
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Validated data collection instruments for birth injuries and obstetric violence.

Posted on August 26, 2021 by John

Obstetric violence is considered a violation of the rights to equality, non-discrimination, information, integrity, health, and reproductive autonomy of women. It occurs in both public and private medical practice during pregnancy, delivery, and postpartum care. There is a growing global commitment to address this challenge, that has been supported by policy statements from the World Health Organization (WHO). Medicalization and pathologizing abuse of natural birth processes have been identified as obstetric violence patterns. Indigenous women and women who live in rural areas are particularly vulnerable to this kind of abuse. A new instrument called EPREVO has been developed to measure obstetric violence in Ecuador and the objective of this work is to validate its reliability and structural dimensionality.

Fors, M., Falcon, K., Brandão, T., Vaca, A., Cañadas, S., & Viada González, C. E. (2021). Reliability and Dimensionality of EPREVO (“Experiencias de Parto Relacionadas a Violencia Obstétrica”): Development of a New Instrument, Ecuador. International journal of women’s health, 13, 569–577.

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What considerations should be given during the patient handover between ED and intensive care unit (ICU)?

Posted on August 25, 2021 by John

“The transfer of information between nurses from emergency departments (EDs) and critical care units is essential to achieve a continuity of effective, individualized and safe patient care. The aim of this study was to explore the process of patient handover between ED and intensive care unit (ICU) nurses when transferring a patient from ED to the ICU. Qualitative analysis of the data revealed that there was no structured and consistent approach to how handovers actually occurred. Nurses from both ED and ICU lacked clarity as to when the actual handover process began. Nurses from both settings recognized the importance of the information given and received during handover and deemed it to have an important role in influencing quality and continuity of care. Nurses from both departments would benefit from a structured framework or aide memoir to guide the handover process. Collaborative work between the nursing teams in both departments would further enhance understanding of each others’ roles and expectations.”

McFetridge, B., Gillespie, M., Goode, D., & Melby, V. (n.d.). An exploration of the handover process of critically ill patients between nursing staff from the emergency department and the intensive care unit . Nursing in Critical Care.,12(6), 261-269.
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Restraint usage in hospitals. Practice guidelines and alternatives.

Posted on August 6, 2021 by John

“Restraints are likely to negatively affect patients’ health and therefore a reduction in their usage is recommended for all health-care settings. To date, research on restrictive practices has concentrated on mental health and long-term care settings. To ensure restraints are used as little as possible in the acute-care hospital setting, it seems important to investigate more comprehensively the use of restraints, to include all types of restraints irrespective of ward type or subpopulations and to identify factors associated with restraint use. Restraints are often utilised in hospitals in complex care situations such as with patients at risk of falling or with delirium. When using restraints the consideration of processes like documentation and evaluation shows great potential for improvement. Standardisation of these processes and education of the interprofessional team could be beneficial for raising awareness and for the sustainable reduction of restraint use.”

Thomann, S., Zwakhalen, Richter, Bauer, & Hahn. (2021). Restraint use in the acute-care hospital setting: A cross-sectional multi-centre study. International Journal of Nursing Studies,114, 103807.

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Patient participation in recording fluid input/output

Posted on June 24, 2021 by John

“The accurate documentation and maintenance of fluid balance charts constitute an integral part of nursing care. However, inaccuracies in fluid balance charting by nurses often occur. Inaccurate charting can result in delayed interventions, affecting the safety of patients. It has been found that fluid intake charting in an acute surgical inpatient ward is highly inaccurate. Many expressions of dissatisfaction are evident among medical healthcare professionals and patients regarding the accurate updating of the charts. Therefore, evidence-based measures need to be implemented in order to improve the safety of patient care through accurate recording of patients’ fluid intake”

Liaw, Y., & Goh, M. (2018). Improving the accuracy of fluid intake charting through patient involvement in an adult surgical ward: A best practice implementation project. JBI Database of Systematic Reviews and Implementation Reports.,16(8), 1709-1719.
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Evidence Matters

Evidence-based information for Emory

Author Archives: John

What is the evidence based standard of care for patient monitoring during intravenous immunoglobulin infusion?

What are some current fall prevention interventions for hospitalized patients?

Validated data collection instruments for birth injuries and obstetric violence.

What considerations should be given during the patient handover between ED and intensive care unit (ICU)?

Restraint usage in hospitals. Practice guidelines and alternatives.

Patient participation in recording fluid input/output