THL124 Research In Nursing

ABSTRACT

The study is focused on analysing risk of failures of peripheral intravenous catheters with use of skin glue in which researcher aims at experimenting the situation within time frame of 48 hours. In this study, the investigator implemented that use of Randomised controlled method where the sample of study was 360 adults patients, from where it has been analysed that Cyanoacrylate method supports intravenous setting more effectively in comparison to standard care practices of emergency department (Bugden and et.al., 2016). Thus, in this study, skin glue was applied to skin insertion site of IV intravenous setting.

RESEARCH DESIGN

Design of research plays an important role in study because it helps the scholar in defining basis of study where individual aims at analysing procedure to conduct learning. The study related to medical findings involve key aspects, that is, planning, performance, documentation, analysis and publication (Creswell and Poth, 2017). There are various types of research designs, that is, descriptive, correlational, semi experimental, review and experimental. Every research design is used in different type of study in accordance with sampling and data collection. In research on Skin Glue Reduces the Failure Rate of Emergency Department–Inserted Peripheral Intravenous Catheters, the scholar implemented the use of experimental deign. The focus of study is on practical results therefore the researcher aimed at comparing two clinical practice that is standard care and skin glue in intravenous setting. The study is single site which is phase of clinical practices in which the learner aims at practically involving and testing of certain clinical trials.

Further, the experimentation in study is based on 2 arms where specific clinical setting is given to group of patients in order to derive findings for reaching on common conclusion. The two arm experimentation in this study helped the scholar in reducing change of biases results because in this, same intravenous setting is enabled with every sampled patients.  Implementing 2 arm study in medical researches play an important role as it helps the scholar in enabling positive and reliable response to derive objectives and research questions. Further, it establishes a systematic setting for conducting the experiment.

SAMPLE

Sampling is the most crucial part of study as in this, the scholar aims at choosing small number of population among the large group of possible individuals. It is the base for study because these are sources or individuals who support data and analysis of the learning (Toye, Williamson and Lamb, 2016). There are various sampling methods like cluster, random, stratified, probable, non-probable, etc. Every method offered different types of data collection and analysis in accordance with the results. However, in this study, the researcher implemented the use of random sampling, where the sample was 360 adult patients in which practitioner is focused on exclusion patients who have blood stream infection, extreme sensitivity and e one who did not agreed for experimentation. Thus, in accordance with sample, it can be said that the focus of individual on choosing sample was to ensure that every participant has equal chance to every observation because in this, person aims at comparison to clinical and medication setting of emergency department that is single and standard care to peripheral intravenous catheters.

DATA COLLECTION

Collection of data is the most critical part of study as it is focused on gathering of information with regard to aim and objectives of research. It acts as a base for scholar because on the basis of assembled data, researcher draw findings and results (Bathelt and Glückler, 2017). There are two types of data collection processes, that is, primary and secondary where the secondary data is based on past facts and findings that is collected via governmental publication, journals, articles, books, magazines, etc. However, primary information is based on present findings and information collection.

In this study, the scholar will implement the use of primary data collection where the researcher has performed controlled trials of 380 peripherals intravenous catheters on 260 sampled patients. Apparently, in this study, the primary results of test will be based on failure of stand care with 48 hours in comparison to skin glue. Apart from this, the secondary results will be based on nursing practices, failure of intravenous catheter, dislodgement, occlusion and risk of infection. Thus, researcher implemented the use of secondary information in order to develop critical understanding over experimentation and controlled trials in order to minimize t risk of patient’s safety (Bugden and et.al., 2016). Hence, in primary data assembling, the focus of person was on controlling uncertain and risk to sampled patients, who agreed for experimentation. Patient’s safety was the prior and foremost concern of practitioner in this process because experimentation is related to intravenous clinical setting which is directly concerned to infusion of body fluids with additives.

DATA ANALYSIS

Analysing data is the last and most complex part of study as in this, the researcher aims at drawing outcomes and findings from entire study. There are various data analysis methods which are used for different purposes such as qualitative which is used for analysing information on the basis of observation with the help of themes. Further, there is quantitative which is for analysing information in numerical terms with the help of mathematical tools. Apart from this, there is randomised controlled trials which are specially used for medical purposes. However, in this study, scholar has implemented the use of controlled trials where the information will analyse on basis of experiments. Thus, it can be said that scholar implemented the used non blinded approach, which assisted the researcher in reducing chance of biases during test and analysing results. 

RESULTS

In accordance with experiments and randomised controlled trials on 360 patients, it has been evaluated that use of skin glue reduced failure by 10 percent in Peripheral intravenous catheter setting in comparison to standard care. Further, it has been determined that use of Cyanoacrylate in emergency department for intravenous setting which demonstrated, 7 percent decrease in removal (dislodgement). Thus, from the study, it has been implied that there were no signs of infection and unsafe experimentation during and after trails of clinical setting. The results can be outlined by stating that Inflammation and blockage were also low with use of skin glue but it cannot be significant because the Phlebitis and occlusion depends on patients and their immunity.

CONCLUSION

The study summarized about supporting use of skin glue in peripheral intravenous catheters in emergency department. Form the study, it has been denoted that skin glue can be used by physicians and practitioners during insertion site. However, from the study, it has been outlined that cyanoacrylate is used by physician to secure clinical setting in order to minimize the risk of removal of injected plastic syringe (Jaff and et.al., 2011). Further, it has been evaluated that these practices and use of substance was only to analyse its uses for emergency department. Apparently, to make research effective and reliable, the scholar implemented the use of experimental design where sample was 360 patients. The study was conducted with the help of randomised controlled trials, the tool which is specifically used for medical studies.  Thus, from the investigator, it has been outlined that skin glue is an effective and supportive substance and can be used to reduce that risk of removal in peripheral intravenous catheter. Hence, from the study, it has been concluded that use of cyanoacrylate in clinical setting of emergency department is supportive for dislodgement.

RELEVANT CLINICAL NURSING PRACTICE

Clinical nursing practices play an important role in peripheral intravenous catheters because the practitioners ensure safety and care of experimentation and medical setting. Like in this study, the scholar excluded adults who have immunocompromised which is a blood stream infection (Nurses Initiating and Administering Intravenous Therapy in Community Settings, 2017). Complete labelling of drug, dilution rate, dose and volume is mandatory practice which needs to done responsible nurse with his or her signature. Further, it is important for the practitioners to clean IV cannula with rubber bung with alcohol Swab. However, in case of disconnected cannula, it is important for the nurse to immediately disconnect with proper and flush it for avoiding infection. Further, it is the responsibility of practitioner to clean the blood substances and syringe driver in order to prevent outward flow of blood (Rickard and et.al., 2012).

Label infusion is the foremost clinical nursing practice which comprises labelling of fluid bag with proper date and time. Further, it is important for the practitioner to describe about the nearest line to pump in cases of multiple line connected. Hence, in accordance with the label, it is important for health practitioners to ensure labelling with appropriate time, patient name and signature of nurse who has been responsible to keep check on specific patient.

Apart from this, relevant clinical nursing practice with regard to peripheral intravenous catheters, states that the practitioners are responsible for changing IV bags and lines on appropriate time mentioned in prescription. In this, the focus of individuals is on additives and non-additives in infusion, Lipid and blood products. However, in bag change and line change, the practices of nurses focus on changing non additives' infusion within 72 hours. Apparently, bag change of additive infusion is within 24 hours whereas line is changed in every 72 hours. The bad of lipid is changed by nurses in every 24 hours and line is changed in every 72 hours (Tuffaha and et.al., 2014). However, in case of blood products, the bag is changed in every 4 hours and line is changed up to 12 hours in order to minimize risk of disconnection and outward flow of body fluid.

Removal of peripheral intravenous catheters is due to extravasation, infiltration, discomfort, signs of infection and swelling. In such cases of removal, the practices need to ensure hand hygiene where the nurses aim at wearing non sterile gloves. Further, it is important for the practitioner to carefully remove clinical setting (Wallis and et.al., 2014).  The removal of IV setting leads to outward flow of blood for which it is important for the nurses to hold sterilize cotton wool to place it to exit site to block flow. However, nursing practices in intravenous setting play a critical role in deriving supportive setting for dislodgement. The nurse’s practice for intravenous ensures use of safe medication equipment and products. Further, checking intravenous setting and products against prescription is another responsibility which helps the health professionals in establishing safe practices (Nurses Initiating and Administering Intravenous Therapy in Community Settings, 2017). Hence, it can be outlined that following of nursing practices in clinical setting for peripheral intravenous catheters help practitioners and professionals in managing safe and secured patient care in health care organisation.

REFERENCES

• Bathelt, H. and Glückler, J., 2017. Relational research design in economic geography.The New Oxford Handbook of Economic Geography.
• Bugden, S. and et.al., 2016. Skin glue reduces the failure rate of emergency department–inserted peripheral intravenous catheters: A randomized controlled trial. Annals of emergency medicine, 68(2), pp.196-201.
• Creswell, J. W. and Poth, C. N., 2017. Qualitative inquiry and research design: Choosing among five approaches. Sage publications.
• Jaff, M.R. and et.al., 2011. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation, 123(16), pp.1788-1830.
• Rickard, C.M. and et.al., 2012. Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. The Lancet, 380(9847), pp.1066-1074.
• Toye, F., Williamson, E. and Lamb, S. E., 2016. What value can qualitative research add to quantitative research design? An example from an adolescent idiopathic scoliosis trial feasibility study. Qualitative health research. 26(13).pp.1838-1850.
• Tuffaha, H.W. and et.al., 2014. Cost-effectiveness analysis of clinically indicated versus routine replacement of peripheral intravenous catheters. Applied health economics and health policy, 12(1), pp.51-58.
• Wallis, M.C. and et.al., 2014. Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Infection Control & Hospital Epidemiology, 35(1), pp.63-68.

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