TY - JOUR
T1 - Implanted Port Access in the Emergency Department
T2 - A Unit-Level Feasibility Study of a Nurse-Led Port Access Algorithm
AU - Jizba, Theresa A.
AU - Baumert, Jennifer M.
AU - Miller, Jennifer
AU - Barnason, Susan
N1 - Publisher Copyright:
© 2021 Emergency Nurses Association
PY - 2021/7
Y1 - 2021/7
N2 - Introduction: The objective of this study was to determine the impact of an emergency nurse-led implanted port access algorithm for ED patients with implanted ports admitted to the hospital. Methods: A feasibility study evaluated the implementation of a central line-associated bloodstream infection algorithm in the emergency department over a 1-month study period. Emergency nurses received central line-associated bloodstream infection education and training for port access algorithm implementation. Pre- and postimplementation surveys measured the nurses’ knowledge, attitudes, and behaviors regarding central line-associated bloodstream infections. The nurses’ perceptions of the algorithm were assessed pre- and postimplementation. ED patient port access and central line-associated bloodstream infection rates were compared with preimplementation rates. Results: Emergency nurses (N = 32) received central line-associated bloodstream infection education and algorithm training. Pre- and postimplementation as well as knowledge, attitude, and behavior surveys were completed by 59% (n = 19) of the nursing staff. Knowledge regarding central line-associated bloodstream infections significantly improved, t (19) = –4.8, P < .001. The nurses’ pre- and postimplementation attitude and behavior scores did not differ significantly. They expressed no concerns regarding implementation of the algorithm; 89% (n = 17) reported that the algorithm “fit well” with the ED workflow, and 21% (n = 4) integrated the patient's decision regarding venous access into their shift report. The ED port access incidence during the study period was 17.6% (n = 3), compared with 83.3% (n = 15) in the month before the study. Discussion: The emergency nurse-led port access algorithm decreased ED port access rates. The nurses’ pre- and postimplementation knowledge of central line-associated bloodstream infections increased. The emergency nurse-led port access algorithm empowered emergency nurses to educate their patients on implanted port access and decreased central line use.
AB - Introduction: The objective of this study was to determine the impact of an emergency nurse-led implanted port access algorithm for ED patients with implanted ports admitted to the hospital. Methods: A feasibility study evaluated the implementation of a central line-associated bloodstream infection algorithm in the emergency department over a 1-month study period. Emergency nurses received central line-associated bloodstream infection education and training for port access algorithm implementation. Pre- and postimplementation surveys measured the nurses’ knowledge, attitudes, and behaviors regarding central line-associated bloodstream infections. The nurses’ perceptions of the algorithm were assessed pre- and postimplementation. ED patient port access and central line-associated bloodstream infection rates were compared with preimplementation rates. Results: Emergency nurses (N = 32) received central line-associated bloodstream infection education and algorithm training. Pre- and postimplementation as well as knowledge, attitude, and behavior surveys were completed by 59% (n = 19) of the nursing staff. Knowledge regarding central line-associated bloodstream infections significantly improved, t (19) = –4.8, P < .001. The nurses’ pre- and postimplementation attitude and behavior scores did not differ significantly. They expressed no concerns regarding implementation of the algorithm; 89% (n = 17) reported that the algorithm “fit well” with the ED workflow, and 21% (n = 4) integrated the patient's decision regarding venous access into their shift report. The ED port access incidence during the study period was 17.6% (n = 3), compared with 83.3% (n = 15) in the month before the study. Discussion: The emergency nurse-led port access algorithm decreased ED port access rates. The nurses’ pre- and postimplementation knowledge of central line-associated bloodstream infections increased. The emergency nurse-led port access algorithm empowered emergency nurses to educate their patients on implanted port access and decreased central line use.
KW - Central line-associated bloodstream infection
KW - Central venous access
KW - Emergency department
KW - Implanted port
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U2 - 10.1016/j.jen.2021.01.010
DO - 10.1016/j.jen.2021.01.010
M3 - Article
C2 - 33714563
AN - SCOPUS:85106292338
SN - 0099-1767
VL - 47
SP - 599
EP - 608
JO - Journal of Emergency Nursing
JF - Journal of Emergency Nursing
IS - 4
ER -