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Synergistic Nursing Professionals in Radiology to Enhance Patient Care
Session Abstracts
JOURNAL OF RADIOLOGY NURSING
rapidity, persistence, and contraindications are compared. Research around off-label use for lumbar punctures is presented along with a recommendation for use. The literature is distilled into a single list placing the most commonly used agents in preferential order. Radiology nurses can combine their patient assessment with this list to choose the most effective skin preparation agent for the procedure.
Improvement of Nursing Skill and Competence Using Interdisciplinary Simulation Training Michelle Connell, RN Assistant Nurse Manager RN, Shands Jacksonville, Jacksonville, FL Co-Presenters: Teresa Cummins, BSN, RN, CEN; Erin Jurgens, RN; Jackie Heiser, RT(R), VI; Daniel Siragusa, MD Nurses completed a survey identifying areas where they lacked confidence in their clinical skills related to highrisk, low-volume medications and procedures in the Interventional Radiology (IR) environment. Based on the results of this survey an educational opportunity was developed to allow the nurses to practice clinical skills in a controlled environment. Nurses were provided a debriefing and a post-educational survey to evaluate the effectiveness of the learning activity. Nurses state an increase in confidence and competence in administering high-risk, low-volume meds and other procedures in the IR environment. Objectives are as follows: Objective 1: To demonstrate how the use of the simulation lab improved patient care and the nurses’ self-reports of clinical competence. Content for Objective 1: Nurses identified a lack of comfort with high-risk, low-volume meds and procedures to include TPA, vasoactive meds, vecuronium, and blood transfusions. Nurses also state a lack of clinical confidence providing care to trauma patients during evening and weekend on-call cases. This led to the development of a simulation educational plan to allow the nurses to practice clinical skills in a controlled setting and to provide feedback and remediation.
Our Journey on the Path to Magnet Status Katherine Duncan, BA, RN, CRN Clinical Nurse III, AHA Instructor, UNC Hospitals, Chapel Hill, NC The magnet distinction is coveted by hospitals around the country. We will review and discuss how we ventured on this journey and helped our hospital achieve 70
magnet status from the radiology nursing perspective. Objectives are as follows: Objective 1: Learner will see the steps involved in completing the magnet application and review. Content for Objective 1: A quick review of the process will be presented and then we implement the process in radiology. Objective 2: Radiology nursing-specific participation. Content for Objective 2: What we did in the process to highlight radiology nursing and how we involved the nursing staff. Objective 3: Pitfalls and successes along the journey will be covered. Content for Objective 3: Recognition of how not everything is perfect in the process and the need for continued review in regards to things to watch for and how we succeeded. Objective 4: Will you be next? Content for Objective 4: Discuss with learners the process or potential at their bases. Synergistic Nursing Professionals in Radiology to Enhance Patient Care Colleen Ellis, BSN, RN, CEN Staff Development Specialist, Radiology, Christiana Care, Newark, DE Co-Presenter: Barbara Griffin, BSN, RN Background: Nurses strive to maintain high ethical standards and personal integrity and require the same of others. Nurses recognize and respect the professional and personal strengths of others. Assimilation of nurses into radiology with emphasis on a synergistic relationship with professional technical staff is vital to the success of the team and to positive patient outcomes in a safe environment. To be a true patient advocate our nurses must incorporate the nursing process with each patient, family member, and the multidisciplinary team. Nurses recognize the many facets of the radiology interdisciplinary team and as we move forward to incorporate the Synergy Model into our department, the unique characteristics of patients, nurses, and technical staff is acknowledged. Synergy moves us forward to provide positive patient and unit-level outcomes. Our goal is finding a common ground and with mutual accountability for daily operations and performance, we engage the staff in advancing education and certification. Nurses and technical staff have joined together to form various performance improvement committees to provide for safe patient outcomes with increased patient satisfaction. Professional practice and clinical inquiry through the interlocking of competencies with technical staff has facilitated learning and collaboration among the team members. We strive to keep the characteristics of patients, nurses, and technical staff at the forefront to maintain synergy within the department to provide maximum, distinctive care for our patients. Objectives
www.radiologynursing.org
JUNE 2012
JOURNAL OF RADIOLOGY NURSING
are as follows: Objective 1: The learner will recognize the unique characteristics of patients, nurses, and technical staff and how to apply synergy to various situations. Content for Objective 1: Various use of diagrams and examples of performance improvement projects that have provided positive patient outcomes.
Session Abstracts
and Group 3Zbacteriostatic normal saline with a benzyl alcohol preservative). The most tolerable solution, as measured by average pain with intradermal needle stick was Group 2. The most efficacious, as measured by average pain at IV cannulation, were Groups 1 and 2. Group 3 was the most cost-effective. Based on these findings Group 2 was found to be the best choice based on tolerability and efficacy.
A Randomized Double-Blind Study Comparing Intradermal Anesthetic Tolerability, Efficacy, and CostEffectiveness of Lidocaine, Buffered Lidocaine, and Bacteriostatic Normal Saline for Peripheral Intravenous Insertion Vivienne Ganter Ritz, BSN, RN-BC
Expanding Educational Resources: An Advocacy for Families/Parents of Local Pediatric Communities Susan Orchard, MSN, RN
IR Nurse Specialist, Shore Health System, Easton, MD
Radiology Nurse, Robert Packer Hospital, Sayre, PA
Purpose: The purpose of this study was to determine the most efficacious, tolerable, and cost-effective intradermal anesthetics currently used for intravenous (IV) site preparation. The central hypothesis was that the three intradermal anesthetic IV site preparations would be equal in efficacy, tolerability, and cost-effectiveness. Design: This was a prospective, randomized, doubleblind study of 256 patients. Methods: Patients who met study eligibility criteria were randomized in a 1:1:1 ratio to Group 1Z1% lidocaine, Group 2Z1% buffered lidocaine, or Group 3Zbacteriostatic normal saline with a benzyl alcohol preservative. Data collected included demographics, surgery information, dominant hand, insertion site, and number of IV catheter sticks for successful IV placement. Patient evaluations for pain were completed after intradermal anesthetic IV site preparation / needle stick and after IV cannulation / catheter needle stick. Findings: Group 2 reported lowest pain levels for average pain from intradermal needle stick (tolerability) and IV cannulation needle stick (efficacy). Groups 1 and 2 had significantly lower average pain scores for IV cannulation than Group 3. Conclusion: The cost-effectiveness of bacteriostatic normal saline as the best choice of interadermal anesthetic is not supported by tolerability and efficacy. The most tolerable anesthetic was 1% buffered lidocaine and the efficaciousness was equal for the lidocaine groups. Therefore intradermal 1% buffered lidocaine is the solution of choice for venipuncture preparation. Objectives are as follows: Objective 1: Contrast the differences between tolerability, efficacy, and cost-effectiveness of three intradermal anesthetics. Content for Objective 1: In this double-blind study, 256 patients meeting eligibility criteria were randomized in a 1:1:1 ratio to one of the three intradermal injection groups prior to intravenous (IV) line insertion (Group 1Z1% lidocaine, Group 2Z1% buffered lidocaine,
While preparing for a minor procedure or surgery, families and patients bear expectations, doubts, and fears about what is going to happen to themselves or their loved ones. The hospital is a strange and unfamiliar place for pediatric patients. Including the family in the hospital environment creates an additional demand in meeting their particular needs. Having access to preprocedural resources can help in preparing families and parents to participate in the care of their child during hospitalization and after discharge (Risso and Braga, 2010). The purpose of this community project is to design an artifact that supplements the verbal information families/parents receive from members of the healthcare team concerning upcoming minor procedures or surgeries. It utilizes the findings from a community assessment of specific boroughs, cities, and towns within the Twin Tiers Regions of Northern Pennsylvania and Southern New York (representative of key Guthrie Healthcare facility locations) to determine the need for the development of such educational materials. Nurse advocacy on behalf of this need for increased pre-procedural educational resources resulted in the creation of an informational brochure pertaining to pediatric medical imaging of the urinary system. This brochure serves to expand family/parental preprocedural knowledge of urinary system testing, reduce family stress in the outpatient hospital setting, and improve patient outcomes of children requiring such healthcare services. Objectives are as follows: Objective 1: Applies foundational theory and knowledge necessary for the development of medical imaging educational materials for families/parents of pediatric communities. Content for Objective 1: Poster Presentation of Community Research Project includes: abstract, overview of the problem, target aggregate, objectives of the project, purpose of the project, theoretical basis, literature review, methodology, community assessment
VOLUME 31 ISSUE 2
www.radiologynursing.org
71
JOURNAL OF RADIOLOGY NURSING
rapidity, persistence, and contraindications are compared. Research around off-label use for lumbar punctures is presented along with a recommendation for use. The literature is distilled into a single list placing the most commonly used agents in preferential order. Radiology nurses can combine their patient assessment with this list to choose the most effective skin preparation agent for the procedure.
Improvement of Nursing Skill and Competence Using Interdisciplinary Simulation Training Michelle Connell, RN Assistant Nurse Manager RN, Shands Jacksonville, Jacksonville, FL Co-Presenters: Teresa Cummins, BSN, RN, CEN; Erin Jurgens, RN; Jackie Heiser, RT(R), VI; Daniel Siragusa, MD Nurses completed a survey identifying areas where they lacked confidence in their clinical skills related to highrisk, low-volume medications and procedures in the Interventional Radiology (IR) environment. Based on the results of this survey an educational opportunity was developed to allow the nurses to practice clinical skills in a controlled environment. Nurses were provided a debriefing and a post-educational survey to evaluate the effectiveness of the learning activity. Nurses state an increase in confidence and competence in administering high-risk, low-volume meds and other procedures in the IR environment. Objectives are as follows: Objective 1: To demonstrate how the use of the simulation lab improved patient care and the nurses’ self-reports of clinical competence. Content for Objective 1: Nurses identified a lack of comfort with high-risk, low-volume meds and procedures to include TPA, vasoactive meds, vecuronium, and blood transfusions. Nurses also state a lack of clinical confidence providing care to trauma patients during evening and weekend on-call cases. This led to the development of a simulation educational plan to allow the nurses to practice clinical skills in a controlled setting and to provide feedback and remediation.
Our Journey on the Path to Magnet Status Katherine Duncan, BA, RN, CRN Clinical Nurse III, AHA Instructor, UNC Hospitals, Chapel Hill, NC The magnet distinction is coveted by hospitals around the country. We will review and discuss how we ventured on this journey and helped our hospital achieve 70
magnet status from the radiology nursing perspective. Objectives are as follows: Objective 1: Learner will see the steps involved in completing the magnet application and review. Content for Objective 1: A quick review of the process will be presented and then we implement the process in radiology. Objective 2: Radiology nursing-specific participation. Content for Objective 2: What we did in the process to highlight radiology nursing and how we involved the nursing staff. Objective 3: Pitfalls and successes along the journey will be covered. Content for Objective 3: Recognition of how not everything is perfect in the process and the need for continued review in regards to things to watch for and how we succeeded. Objective 4: Will you be next? Content for Objective 4: Discuss with learners the process or potential at their bases. Synergistic Nursing Professionals in Radiology to Enhance Patient Care Colleen Ellis, BSN, RN, CEN Staff Development Specialist, Radiology, Christiana Care, Newark, DE Co-Presenter: Barbara Griffin, BSN, RN Background: Nurses strive to maintain high ethical standards and personal integrity and require the same of others. Nurses recognize and respect the professional and personal strengths of others. Assimilation of nurses into radiology with emphasis on a synergistic relationship with professional technical staff is vital to the success of the team and to positive patient outcomes in a safe environment. To be a true patient advocate our nurses must incorporate the nursing process with each patient, family member, and the multidisciplinary team. Nurses recognize the many facets of the radiology interdisciplinary team and as we move forward to incorporate the Synergy Model into our department, the unique characteristics of patients, nurses, and technical staff is acknowledged. Synergy moves us forward to provide positive patient and unit-level outcomes. Our goal is finding a common ground and with mutual accountability for daily operations and performance, we engage the staff in advancing education and certification. Nurses and technical staff have joined together to form various performance improvement committees to provide for safe patient outcomes with increased patient satisfaction. Professional practice and clinical inquiry through the interlocking of competencies with technical staff has facilitated learning and collaboration among the team members. We strive to keep the characteristics of patients, nurses, and technical staff at the forefront to maintain synergy within the department to provide maximum, distinctive care for our patients. Objectives
www.radiologynursing.org
JUNE 2012
JOURNAL OF RADIOLOGY NURSING
are as follows: Objective 1: The learner will recognize the unique characteristics of patients, nurses, and technical staff and how to apply synergy to various situations. Content for Objective 1: Various use of diagrams and examples of performance improvement projects that have provided positive patient outcomes.
Session Abstracts
and Group 3Zbacteriostatic normal saline with a benzyl alcohol preservative). The most tolerable solution, as measured by average pain with intradermal needle stick was Group 2. The most efficacious, as measured by average pain at IV cannulation, were Groups 1 and 2. Group 3 was the most cost-effective. Based on these findings Group 2 was found to be the best choice based on tolerability and efficacy.
A Randomized Double-Blind Study Comparing Intradermal Anesthetic Tolerability, Efficacy, and CostEffectiveness of Lidocaine, Buffered Lidocaine, and Bacteriostatic Normal Saline for Peripheral Intravenous Insertion Vivienne Ganter Ritz, BSN, RN-BC
Expanding Educational Resources: An Advocacy for Families/Parents of Local Pediatric Communities Susan Orchard, MSN, RN
IR Nurse Specialist, Shore Health System, Easton, MD
Radiology Nurse, Robert Packer Hospital, Sayre, PA
Purpose: The purpose of this study was to determine the most efficacious, tolerable, and cost-effective intradermal anesthetics currently used for intravenous (IV) site preparation. The central hypothesis was that the three intradermal anesthetic IV site preparations would be equal in efficacy, tolerability, and cost-effectiveness. Design: This was a prospective, randomized, doubleblind study of 256 patients. Methods: Patients who met study eligibility criteria were randomized in a 1:1:1 ratio to Group 1Z1% lidocaine, Group 2Z1% buffered lidocaine, or Group 3Zbacteriostatic normal saline with a benzyl alcohol preservative. Data collected included demographics, surgery information, dominant hand, insertion site, and number of IV catheter sticks for successful IV placement. Patient evaluations for pain were completed after intradermal anesthetic IV site preparation / needle stick and after IV cannulation / catheter needle stick. Findings: Group 2 reported lowest pain levels for average pain from intradermal needle stick (tolerability) and IV cannulation needle stick (efficacy). Groups 1 and 2 had significantly lower average pain scores for IV cannulation than Group 3. Conclusion: The cost-effectiveness of bacteriostatic normal saline as the best choice of interadermal anesthetic is not supported by tolerability and efficacy. The most tolerable anesthetic was 1% buffered lidocaine and the efficaciousness was equal for the lidocaine groups. Therefore intradermal 1% buffered lidocaine is the solution of choice for venipuncture preparation. Objectives are as follows: Objective 1: Contrast the differences between tolerability, efficacy, and cost-effectiveness of three intradermal anesthetics. Content for Objective 1: In this double-blind study, 256 patients meeting eligibility criteria were randomized in a 1:1:1 ratio to one of the three intradermal injection groups prior to intravenous (IV) line insertion (Group 1Z1% lidocaine, Group 2Z1% buffered lidocaine,
While preparing for a minor procedure or surgery, families and patients bear expectations, doubts, and fears about what is going to happen to themselves or their loved ones. The hospital is a strange and unfamiliar place for pediatric patients. Including the family in the hospital environment creates an additional demand in meeting their particular needs. Having access to preprocedural resources can help in preparing families and parents to participate in the care of their child during hospitalization and after discharge (Risso and Braga, 2010). The purpose of this community project is to design an artifact that supplements the verbal information families/parents receive from members of the healthcare team concerning upcoming minor procedures or surgeries. It utilizes the findings from a community assessment of specific boroughs, cities, and towns within the Twin Tiers Regions of Northern Pennsylvania and Southern New York (representative of key Guthrie Healthcare facility locations) to determine the need for the development of such educational materials. Nurse advocacy on behalf of this need for increased pre-procedural educational resources resulted in the creation of an informational brochure pertaining to pediatric medical imaging of the urinary system. This brochure serves to expand family/parental preprocedural knowledge of urinary system testing, reduce family stress in the outpatient hospital setting, and improve patient outcomes of children requiring such healthcare services. Objectives are as follows: Objective 1: Applies foundational theory and knowledge necessary for the development of medical imaging educational materials for families/parents of pediatric communities. Content for Objective 1: Poster Presentation of Community Research Project includes: abstract, overview of the problem, target aggregate, objectives of the project, purpose of the project, theoretical basis, literature review, methodology, community assessment
VOLUME 31 ISSUE 2
www.radiologynursing.org
71