Amiodarone education

[bnaiya]

Our Telemetry unit will start administering Amiodarone IV. I was wondering if the nurses should have a formal competency or education(Powerpoint, education packet, and a test). Any suggestions would be helpful. If a competency is preferred and someone give me an idea of what should the competency consist of. :confused::confused:

[MunoRN, RN]

Not being titrated you don't need the same type of education you would need for pressors or inotropes, but Nurses should be assessing effect and side effects: QTc, bradycardia, hypotension, liver enzymes, signs of thyroid toxicity, signs of pulmonary efffects (with longer term use), etc.

We use an orderset for our Amiodarone protocols which includes what to monitor, parameters for QTc changes, as well as rates for Supraventricular and ventricular rhythms, and includes when to switch to PO based on patient rhythm.

This should be something that could be covered with short computer module.

[bnaiya]

thanks for the information. I have put together a powerpoint and education packet with test. The nurses are in an uproar because they feel they have to many patients(days: 5:1 or 4:1 and nights 5:1 or 6:1) on a unit that only have 34beds and the only drips are heparin, and,integrillin. The critical educator gave me an insert from Amiodarone dated 2001 and told me her staff uses sticky notes on IV to remind them of switch from 6hrs to 18hr dosing. No ordersets here and I wish i could see how yours are put together so I could do the same at our hospital. I may have to get IT on it. Thanks again....

[bnaiya]

@MunoRN I spoke to our IT about the ordersets. Is there anyway you can email so we can chat about them. They want to know how they are set up and use as a guide for ours(not copy):) [email protected] please

[rn undisclosed name]

thanks for the information. I have put together a powerpoint and education packet with test. The nurses are in an uproar because they feel they have to many patients(days: 5:1 or 4:1 and nights 5:1 or 6:1) on a unit that only have 34beds and the only drips are heparin, and,integrillin. The critical educator gave me an insert from Amiodarone dated 2001 and told me her staff uses sticky notes on IV to remind them of switch from 6hrs to 18hr dosing. No ordersets here and I wish i could see how yours are put together so I could do the same at our hospital. I may have to get IT on it. Thanks again....

Sticky notes??? Those things fall off. Anyways it works much better to program your pump for 6 hours so it will beep and you know to change the rate. Unless, of course you have an IV pump that allows you to do multistep changes.

I have worked on 3 different telemetry units and we have always done amiodarone. If you are not titrating it then I don't see what the big deal is. I think they're spoiled. Everywhere I have worked at we have done heparin, amio, dopamine, dobutamine, dilt, and milrinone. I'm sure there are some others on top of that.

[bnaiya]

I agree they are spoiled! Can someone please come tell them what a Telemetry consists of. How about those patient ratios?

[nyrn5125]

our ratio in tele is 1:8 with amio dopa, lidocaine, dobutrex, cardizem...

[nursej22, MSN, RN]

I would add that another complication to watch for is infiltration/extravasation.

Amiodorone can cause a wicked phlebitis.

I find that amiodorone is less work and fewer problems than blood transfusion.

[LoveANurse09]

^ yes BAD infiltration! My unit takes all those drips as well,but our ratio is 1:5.

[hope3456, ASN, RN]

our ratio in tele is 1:8 with amio dopa, lidocaine, dobutrex, cardizem...

OMG....so do you have alot of support staff and what can they do for you?

[CCL RN, RN]

our ratio in tele is 1:8 with amio dopa, lidocaine, dobutrex, cardizem...

That's obscenely unsafe...