How fast is too fast? a practice change in umbilical arterial catheter blood sampling using the Iowa Model for Evidence-Based Practice.
A multidisciplinary team at the University of Iowa Children's Hospital utilized the Iowa Model of Evidence-Based Practice to Promote Quality Care as a basis for changing practice related to the rate of drawing and flushing umbilical artery catheters in very low birth-weight infants. Research indicates that rapid withdrawal of blood or flushing of catheters that are placed in the aorta can affect cerebral blood flow velocity, volume, and oxygenation. Alteration of cerebral blood flow in premature infants has been correlated with the incidence of intraventricular hemorrhage and periventricular leukomalacia, which can be a significant cause of morbidity and mortality in this population. Using this research as a guide, along with expert opinion, scientific principles, and theories, a new standard of practice was written, and the staff educated.
Gordon
Myrna
M
University of Iowa Children's Hospital, University of Iowa Hospitals and Clinics, Iowa, USA. myrna-gordon@uiowa.edu
Bartruff
Lisa
L
Gordon
Sara
S
Lofgren
Maria
M
Widness
John A
JA
D001783:Blood Flow Velocity; D001800:Blood Specimen Collection / Q000009:adverse effects / Q000379:methods* / Q000592:standards*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology; D019317:Evidence-Based Medicine; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D007484:Iowa; D007511:Ischemia / Q000517:prevention & control; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014469:Umbilical Arteries / Q000502:physiology