"Implementation of an Amiodarone Infusion Nurse Practice Guideline to R" by Kristen N. Cottrill

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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