to explore research findings and evaluate need of practice change in thailand
DESCRIPTION
Put Evidence in to Practice: PICC Team development in Thailand Pongpak Pittayapan, RN, DNSc Nursing Department, Siriraj Hospital, Mahidol University, Bangkok. RECOMMENDATIONS. BACKGROUND. The Iowa Model of Evidence-Based Practice to Promote Quality Care. - PowerPoint PPT PresentationTRANSCRIPT
To explore research findings and evaluate need of practice change in Thailand.
MATERIALS and METHODSMATERIALS and METHODS
BACKGROUNDBACKGROUND
Put Evidence in to Practice: PICC Team development in Thailand
Pongpak Pittayapan, RN, DNScNursing Department, Siriraj Hospital, Mahidol University, Bangkok.
About 85 % of the patients who admit at Surgical Department, Siriraj Hospital have intravenous catheters placed each year,
which can divide to peripheral IVs 75% and central line 10%. The surveillance of PIVs phlebitis is rare in the Surgical department, Siriraj hospital, found 27.6% (Danchaivijtr, et al., 1995) and 8.8 % later (Pittayapan, et.al., 2008). Awareness of magnitude problems
of PIVs phlebitis, we want to elucidate the incidence and associated factors to improve quality of infusion care in our
institution.
The Iowa Model of Evidence Based Practice is the conceptual framework to analyze the findings of the research title on “The factor associated with peripheral phlebitis in surgical patients” which done in 2009. The sample of the study consisted of 1,544
surgical patients with 3,252 insertion sites. Two concepts derived from the model are Problem focus triggers and
Knowledge focus triggers given the way to consider a decision point and priority need of practice change in the institution.
RECOMMENDATIONSRECOMMENDATIONS
This review of research findings can bridge to policy by putting the standard of infusion nursing into practice, Intravenous Therapy Team
and PICC team in our institution.
OBJECTIVEOBJECTIVE
Reference:
1. Danchaivijirt S, et al. Infusion Phlebitis in Medical and Surgical Patients in Siriraj Hospital. Journal Med Associate Thai. July; 1995
2. Maki, D.G., & Ringer, M. Risk factors for infusion related phlebitis with small peripheral venous catheters. Annals of Internal Medicine,1991;114(10), 845-854
3. Titler, M.G., et.,al. The Iowa Model of Evidence-Based Practice to Promote Quality Care. Critical Nursing of North America, 13 (4), 497-509..
55%35%
10%0%
0% Grade 0Grade 1Grade 2Grade 3Grade 40
5
10
15
20
25
30
1995 2008
incidence ofphlebitis
The Iowa Model of Evidence-Based Practice to Promote Quality Care
KEY FINDINGSKEY FINDINGS•skill of nurse such as insertion site, number of insertion attempts, pain at attempt associated with phlebitis (p<0.05)• material such as type of dressing, type of catheter, duration of catheter dwelling associated with phlebitis (p<0.05)•Infusion Therapy such as type of anti-infective drug, parenteral nutrition, and chemotherapy associated with phlebitis (p<0.05)
POLICY IMPLICATIONSPOLICY IMPLICATIONS• skill of nurse provides a direct link to the Implication of Intravenous
Therapy Team, •material provides a direct link Implication by the use of IV best
practice standards, and •Infusion Therapy can provide a direct link to Implication with the
suggestion of dilution, rate and infusing, central line and PICC line.
PLAN CHANGE IN PRACTICEPLAN CHANGE IN PRACTICE• By Jan 2014, discussed the problem of risk data with multidisciplinary team in the hospital.• By Feb 2014, discussed the problem of legal and role of nurse in PICC doing with Thailand Nursing Council.• By March 2014, added a module of training to collaborate with neonate PICC team in faculty of Siriraj Medicine (by inviting the INS president to be the speaker).• By May 2014, to join INS Meeting for partnership to develop PICC training course in Thailand.• By June 2014, to implement the PICC training course at Siriraj Hospital• Evaluate Process & Outcome