What are some ways to increase compliance of VTE Prophylaxis as well as barriers?

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Biffl WL et al. ““Leaning” the process of venous thromboembolism prophylaxis.” The joint commission journal on quality and patient safety 37.3 (2011):99.

Tiryaki, Funda ; Nutescu, Edith A. ; Hennenfent, Joel A. ; Karageanes, Annette M. ; Koesterer, Larry J. ; Lambert, Bruce L. ; Schumock, Glen T.Anticoagulation therapy for hospitalized patients: Patterns of use, compliance with national guidelines, and performance on quality measures. American Journal of Health-System Pharmacy, 2011 Jul 1; 68 (13): 1239-44.

Wang Z et al.”Compliance with surgical care improvement project measures and hospital-associated infections following hip arthroplasty.” Journal of Bone and Joint Surgery; American volume 94.15 (2012):1359.

Brown, Alexandra Preventing venous thromboembolism in hospitalized patients with cancer: Improving compliance with clinical practice guidelines.
American Journal of Health-System Pharmacy, 2012 Mar 15; 69 (6): 469-81.

Li F ; Walker K ; McInnes E ; Duff J Testing the effect of a targeted intervention on nurses’ compliance with “best practice” mechanical venous thromboembolism prevention. Journal of Vascular Nursing, 2010 Sep; 28 (3): 92-6.

Gaston, Sherryl ; White, Sarah louise Venous thromboembolism ( VTE) risk assessment: Rural nurses’ knowledge and use in a rural acute care hospital. International Journal of Nursing Practice, 2013 Feb; 19 (1): 60-4.

Gaston, Sherryl, White, Sarahlouise, Misan, Gary. Venous Thromboembolism (VTE) Risk Assessment and Prophylaxis: A Comprehensive Systematic Review of the Facilitators and Barriers to Healthcare Worker Compliance with Clinical Practice Guidelines in the Acute Care Setting. The JBI Library of Systematic Reviews. 10(57):3812-3893, 2012.

Databases: CINAHL and Joanna Briggs. Keywords: VTE, Venous Thromboembolism, compliance, barriers

Reviewed by John Nemeth 4/14

Guidelines for Continuous Pulse Oximetry

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Jeffrey J. Pretto, Teanau Roebuck, Lutz Beckert and Garun Hamilton. Clinical use of pulse oximetry: Official guidelines from the Thoracic Society of Australia and New Zealand. Respirology. 2014 Jan;19(1):38-46. doi: 10.1111/resp.12204. Epub 2013 Nov 20.

Pulse Oximetry. [Recommended Practices], 2016.

Dao Le, Long Khanh,. Pulse Oximetry: Clinician Information. {Evidence Summaries]. 2016.

Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: An updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology. 2016 Mar;124(3):535-52. doi: 10.1097/ALN.0000000000000975.

Pedersen T1, Nicholson A, Hovhannisyan K, Møller AM, Smith AF, Lewis SR. Pulse oximetry for perioperative monitoring. Cochrane Database Syst Rev. 2014 Mar 17;(3):CD002013. doi: 10.1002/14651858.CD002013.pub3. PubMed PMID: 24638894 .

I searched PubMed, CINAHL AND Joanna Briggs.   Keywords:  Continuous Pulse Oximetry Guidelines.

Updated Joanna Briggs and Cochrane links, 10/16/2017 ldt

Use of betadine on postoperative surgical sites

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“Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery.” Spine (Philadelphia, Pa. 1976) 30.15 (2005):1689.

Lid scrub may reduce endophthalmitis rate when used with topical Betadine… including commentary by Trattler WB. Ocular Surgery News 2009 vol:27 iss:19 pg:16

Swenson BR ; Hedrick TL ; Metzger R ; Bonatti H ; Pruett TL ; Sawyer RG. Effects of preoperative skin preparation on postoperative wound infection rates: a prospective study of 3 skin preparation protocols. Infection Control & Hospital Epidemiology, 2009 Oct; 30 (10): 964-71.

Giordano, Salvatore, et al. “Povidone-iodine combined with antibiotic topical irrigation to reduce capsular contracture in cosmetic breast augmentation: a comparative study.” Aesthetic surgery journal 33.5 (2013):675-680.

Haas, David Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database of Systematic Reviews. 2014 Dec 21;(12):CD007892. doi: 10.1002/14651858.CD007892.pub5.

Spinal Surgery: Prevention and Management of Infection. [Recommended Practices] 2013

Searched CINAHL, PubMed & Joanna Briggs. Keywords: Betadine or Povidone-iodine, postoperative

Reviewed by John Nemeth 4/14

Updated links for last two items, 10/16/2017 ldt

What is the effectiveness of sitters for preventing patient falls?

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Adams, Jewel, and RobertaKaplow. “A sitter-reduction program in an acute health care system.” Nursing economic$ 31.2 (2013):83-89.

Spiva, LeeAnna, et al. “An evaluation of a sitter reduction program intervention.” Journal of nursing care quality 27.4 (2012):341-345.

Tzeng, Huey-Ming, Chang-YiYin, and JulieGrunawalt. “Effective assessment of use of sitters by nurses in inpatient care settings.” Journal of advanced nursing 64.2 (2008):176-183.

Harding, Andrew D. “Observation assistants: sitter effectiveness and industry measures.” Nursing economic$ 28.5 (2010):330-336.

“Falls/ambulation: Reducing sitter use: Decision outcomes.” Nursing Management 42.12 (2011):37.

Searched CINAHL and PubMed. Keywords: sitter and (fall or falls)

Reviewed by John Nemeth 4/14

What is the evidence behind recommended syringe size in pushing medications through IVs?

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No relevant references were identified in searches of Joanna Briggs, PubMed and CINAHL for combinations of these terms:
Iv push, Infusion, Catheter
Complications, adverse effects, adverse events, rupture
Syringe
Size, diameter

A search on Google revealed a discussion board on your topic.
http://allnurses.com/infusion-nursing-intravenous/question-about-piccs-241871-page3.html

There was a reference in the discussion board to this article:
Catheter Connection Column. Journal of Vascular Access Devices. Volume 3 No 3,  Fall 1998

A cited reference search on this reference in CINAHL identified two papers that cite the it:
Douglas L, et al.  Central venous access devices: review of practice.  Paediatric Nursing, 2009 Jun; 21 (5): 19-22.

Dougherty L.  Central venous access devices.  Nursing Standard, 2000 Jul 12-18; 14 (43): 45-50, 53-4.

jkn March 2014

Is use of a secondary IV, or piggyback system, reduce the rate of central line-associated bloodstream infections?

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A search of Joanna Briggs for the term piggyback identified several evidence summaries and recommendations.  Each of them cited the 2002 CDC guidelines as evidence in discussing piggyback systems.

MMWR Recomm Rep. 2002 Aug 9;51(RR-10):1-29.
O’Grady NP, et al.  Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.

On p. 11, the guidelines state that “modified piggyback systems have the potential to prevent contamination…” and cite this single study:

JPEN J Parenter Enteral Nutr. 1992 Nov-Dec;16(6):581-5.
Inoue Y, et al.  Prevention of catheter-related sepsis during parenteral nutrition: effect of a new connection device.

A search of PubMed was conducted using the following terms:
(piggyback OR secondary iv OR (secondary AND infusion)) AND infections AND prevention AND central venous catheters

The results include the Inoue study.  No other studies focus on prevention of catheter-associated bloodstream infections, but may report data on infection rates, which may also be useful.  However, the populations for most of the other studies were neonates.

jkn 3/14

What is the standard of care for the post-operative patient who received spinal anesthesia?

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Searches of PubMed, The Joanna Briggs Institute EBP Database, and the National Guideline Clearinghouse yielded the following practice guideline.

Whitaker Chair, D K, et al. “Immediate post-anaesthesia recovery 2013: Association of Anaesthetists of Great Britain and Ireland.” Anaesthesia 68.3 (2013):288-297.

The abstract states, “The standard of nursing and medical care should be equal to that in the hospital’s critical care units.”

Reviewed 4/8/2014 ldt