Latest Comments by OneDayAtATime12

OneDayAtATime12 985 Views

Joined: Aug 4, '12; Posts: 4 (25% Liked) ; Likes: 1

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    I have kind of decided to "botch" the tubing idea as there is not much evidence regarding that, however there is quite a bit of research specifically about the IV catheter change dates, including a meta-analysis. It was updated in 2013- "Clinically-indicated replacement versus routine replacement of peripheral venous catheters" published by Wiley.

    The CDC recommends-
    Replacement of Peripheral and Midline Catheters
    There is no need to replace peripheral catheters more frequently than every 72-96

    hours to reduce risk of infection and phlebitis in adults [36, 140, 141]. Category 1B
    No recommendation is made regarding replacement of peripheral catheters in adults

    only when clinically indicated [142

    144]. Unresolved issue

    -----I am not exactly sure what "unresolved issue" means. I've read that the CDC needs more information about this before they can make a final recommendation? I know that in my current work setting the policy is to change the IV every 72-96 hours regardless of whether it works or not.

    ---I am ultimately stuck. I have already done a QI project in undergrad regarding hourly rounding. I can not think of anything else on our unit specifically that could use improvement that as nurses we have the ability to change (obviously I can't improve staffing, change policies, etc.) I was under the impression that for this project we had to find something that nursing interventions could specifically improve. Our fall scores have improved, pt satisfaction is up, and our pressure ulcer rates are below standard. I am racking my brain to try to think of something worth writing about. Thank you again Asystole.

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    Thank you Asystole! I have no idea what to do for my project anymore. After delving into the research I've found that the current CDC guidelines regarding IV catheter change dates may be a little behind the times. Some compelling research within the last few years suggests that changing IV's when clinically indicated only did not show an increase in blood stream infections, increased pt satisfaction, and reduced facility costs. I have emailed my professor to see about modifying my original project. We were supposed to "Identify something in need of improvement in our current work setting and develop a QI plan using the model for improvement and propose changes to test and implement." I think the research is very compelling and I would like to use it somehow, but the only way for me to do that would be to hypothetically change the current policy and go from there regarding changes to test, etc. Thank you so much for the response and input. This is my first semester of grad school and I am feeling extremely overwhelmed!

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    Hello all! For my CNS program I have to design a quality improvement project. On the unit in which I currently work, our IV catheter/tubing change date compliance is very poor (about 20-30%)- most of the time they are not even labeled with a date at all. Our policy is tubing is to be changed every 72 hours while catheters can be changed within 72-96 hours. I have come up with a few ways to improve this percentage, just looking for some input/other ideas.
    1. Tape the tubing labels to the IV admin set (they do not come in the set and the labels are currently in a completely different room than the IV admin sets)
    2. Implement a checklist for RN's to complete (Iv/tubing labeled, functioning properly, etc. There is no good place in our charting system to do this)
    3. Require RN's to write IV and tubing change dates on the pt's white board (currently some RN's write the catheter change date, but not all)
    4. Have an inservice to educate staff (a lot of RN's aren't sure what the policy actually is.)

    Any ideas/criticism is appreciated!

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    VivaLasViejas likes this.

    Hello all! I recently passed my NCLEX July 9th. By the grace of my higher power (whom I choose to call God) I attended my first AA meeting July 18th. I can honestly say that the fellowship and program have given me more insight about my disease than four years of nursing school ever could have. I am so grateful to have found the program and even more thankful to be sober today. I started my first job as an RN last Monday and am (for the first time) hopeful for the future. Someone at one of my meetings was telling me about Caduceus meetings, but I have heard pretty negative things about them and haven't found any in my area. I am however very happy to have found this forum, it is nice to know we are not alone and all working towards the same goal. I am always looking to expand my fellowship, especially with people who I can relate to. Please feel free to respond or share your stories. Here's to faith, hope, and fellowship! One day at a time!