Nursing Update 2009 - 2010 - Yale-New Haven Hospital

new knowLeDge,
InnoVATIons AnD ImProVemenTs
nurses trained in Pedi eD
to use intraosseous tool
to inject into marrow
Nurses in Yale-New Haven Children’s
Hospital’s Pediatric Emergency Department
and Pediatric Intensive Care Unit are
now equipped with a palm-sized tool that
allows them to deliver intraosseous drugs
and fluids quickly and safely to a patient
through the marrow, if vascular access
is not available. Nurses in both departments
have been trained to use the EZ-IO
intraosseous power driver, a drill-like
tool that provides emergent intravenous
access in less than 10 seconds and has
proven to be a safe and effective alternative
to intravenous access for the patient.
“Paramedics and EMTs have used this
tool pre-hospital for several years, but it
is a relatively new practice for nurses,”
comments Denine Baxter, RN, patient
services manager, Pediatric ED. “This
safe and reliable tool provides us with an
alternative method of delivering drugs
and fluid when timing is critical for our
young patients.”
Ynhh nurses conduct
range of vital research
Yale-New Haven Hospital is committed to
supporting nursing research as a means
to generate new knowledge, promote innovations
in nursing practice and improve
the quality of care. The hospital’s Nursing
Research Committee, established in 2007,
provides the ongoing research support
needed by staff. The committee matches
nurses with research mentors who guide
them through every phase of the process.
Nurses of varied backgrounds and
tenure have developed research projects
1 2 n u r s I n g u P D A T e
based on questions arising from clinical
practice, nursing and patient education,
health policy, nursing administration or
informatics.
Currently, 18 teams are in various phases
of conducting studies in several clinical
settings. Some of the studies include: use
of an internet-based medication tool that
reduces medication errors in kidney and
liver transplant patients; accuracy of chemstrips
for screening urine prior to chemotherapy
in children; ambulating patients
with pulmonary artery catheters who are
waiting for heart transplant; and a study of
inadvertent hypothermia in adult patients
undergoing interventional radiologic
procedures.
“YNHH is committed to supporting the
scientific inquiry of its nursing staff and
is always looking for ways to increase the
number of studies conducted here,” said
Janet Parkosewich, RN, DNSc, interim
nurse researcher.
hospital introduces
therapeutic hypothermia
into eD
With research supporting the effectiveness
of slowing down brain metabolism
in patients who remain unconscious
after suffering cardiac arrest, YNHH’s
critical care team began providing
therapeutic hypothermia treatment last
year. Arctic Sun is a non-invasive device
that delivers this therapy using waterfilled
hydrogel pads that are applied
directly to the patient’s back, chest and
thighs to lower the body temperature and
maintain it at 91.4° F. Unit-based nurse
educators led the education efforts for
the Arctic Sun equipment and the
Inadvertent hypothermia in
adults undergoing interventional
radiology procedures with
moderate sedation/analgesia
Twenty-five patients participated in this pilot
study. Results demonstrated a wide variation in
temperatures. Mean temperature was 98.54° F
pre-procedure, immediately post-procedure, it
was 98.43° F, whereas temperature in the recovery
area was 98.26° F. Twenty percent of the patients
reported feeling cold immediately post-procedure,
and 28 percent felt cold in the recovery area. Of
those denying thermal discomfort, 75 percent had a
temperature decrease immediately post-procedure,
whereas 69 percent experienced a temperature
decrease in the recovery area.
Percentage not cold
100
90
80
70
60
50
40
30
20
10
0
75%
Immediately
Post-Procedure
69%
Recovery
area