Semester

Fall

Date of Graduation

2022

Document Type

Dissertation

Degree Type

DNP

College

School of Nursing

Department

Not Listed

Committee Chair

Aaron Ostrowski

Committee Co-Chair

Lori Pride

Committee Member

Lori Pride

Abstract

Background: Patients have an increased risk of developing phlebitis when amiodarone is delivered through a peripheral intravenous catheter. In a 32-bed cardiac surgery step-down unit, patients experienced phlebitis at a rate of 28.57% despite following manufacturer recommendations. Individual interventions targeted at amiodarone-related phlebitis have presented mixed results, however, when an amiodarone infusion practice guideline was established, the rate and severity of phlebitis consistently decreased across studies. Purpose: This project aimed to implement an evidence-based amiodarone infusion guideline to reduce phlebitis development or severity in cardiac-surgery step-down patients without a central venous catheter who received a peripheral intravenous infusion of amiodarone. Interventions: An evidence-based amiodarone infusion nurse practice guideline was implemented after determining the rate of phlebitis occurrence in the target population. A post-project staff survey was conducted to determine satisfaction with using the guideline and perceived effectiveness at reducing phlebitis. Methods: The amiodarone infusion nurse practice guideline was based on similar guidelines identified during a comprehensive literature review. The post-project survey was developed using feedback from project site leadership. Pre- and post-intervention data on rates of phlebitis were each collected over a five-month period and the staff survey was conducted after data collection was completed. Statistical analyses were performed to compare pre- and post-intervention data. Results: The project included a total of 104 patients. The pre-intervention population consisted of 70 patients, of whom 16 people had developed a total of 20 incidences of phlebitis. The post-intervention population consisted of 34 patients, of whom 4 people had each experienced one incidence of phlebitis. Though not statistically significant, phlebitis rates between pre-intervention and post-intervention data decreased 16.1%. Survey results were inconclusive due to limited responses. Conclusion: Though not statistically significant, implementation of this nurse practice guideline to reduce the incidence of phlebitis made a clinically significant impact by reducing the incidence of phlebitis in patients receiving peripheral intravenous infusions of amiodarone.

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