Masters Practice Projects

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https://hdl.handle.net/10292/10895
The Masters Practice Projects collection contains digital copies of AUT masters practice projects deposited with the Library since 2017 and made available open access.

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Browsing Masters Practice Projects by Author "Britnell, Sally"

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    Developing a Clinical Referral Pathway for the Management of Difficult Venous Access for Ward Nurses at North Shore Hospital
    (Auckland University of Technology, 2022) Eappen, Seena; Britnell, Sally
    Peripheral Intravenous (IV) access is a commonly performed clinical procedure in hospitals, used to obtain blood samples or administer medications and fluids by the IV route. Various circumstances such as patients with difficult veins, staffing issues, staff experience, and workload demands contribute to a difficult venous access situation (DVA). Delays in obtaining IV access can be detrimental to patient care and treatment, threatening the patient’s health and increasing morbidity and mortality risks. Specifically, early adequate IV access in unwell patients is vital for life-saving therapies. Despite nurses being trained in IV cannulation techniques at North Shore Hospital , many factors intervene to affect the success of cannulation. Examples of factors are patients with poor venous access, very unwell or dehydrated patients with peripheral venous shutdown or those with physical impediments that prevent easy access to veins. Add to this the experience and confidence levels of nurses undertaking the IV cannulation and the process can be very challenging, particularly when IV access is required for critical treatments. Doctors and other expert clinicians are available during business hours if nurses cannot establish IV access. However, there is reduced support for nurses outside business hours (after hours). A clinical support team is available after hours and they can be contacted through the SmartPage© (Alcidion, 2021; Gill et al., 2013a) system. Furthermore, if the clinical support team fail to gain IV access, the anaesthetic team can be contacted to perform ultrasound-guided insertion. There is no clinical policy or pathway regarding this, many nurses are unaware of whom to contact in such a situation and what pathway to follow. Navigating these multiple levels of support can cause delays in administering medications and multiple failed attempts to obtain IV access, resulting in undesirable patient outcomes. A more efficient process is needed for nurses to access rapid support for IV cannulation when patients urgently need it. This practice project aims to streamline a clinical referral pathway for DVA. A review of the current literature is conducted to provide the background information to support this practice project and research topic. The project is then developed using John Hopkins Nursing Evidence-Based Practice (JHNEBP) model. A six-month sample of SmartPage© referral data is collected to identify the trends and situation of the referral process. The data is then analysed using descriptive statistics and thematic analysis. The four key themes identified during the data analysis were ‘patient clinical condition’, ‘difficult access’, ‘staff education and training’, and ‘urgency for treatment.’ These themes, plus the descriptive statistic results, inform improvements to the SmartPage© referral system by streamlining a referral flow chart. The significance of this practice project is that a streamlined clinical referral pathway (flow chart) will lead to a more efficient approach to managing difficult IV access after hours, thereby minimising delays in patient care and treatment and avoiding further complications.
Practice projects are protected by the Copyright Act 1994 (New Zealand). The research projects may be consulted by you, provided you comply with the provisions of the Act and the following conditions of use:
  • Any use you make of these documents or images must be for research or private study purposes only, and you may not make them available to any other person.
  • Authors control the copyright of their research projects. You will recognise the author’s right to be identified as the author of the research project, and due acknowledgement will be made to the author where appropriate.
  • You will obtain the author’s permission before publishing any material from the research project.