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Reducing the Incidence of Amiodarone‐related Phlebitis Through Utilization of Evidence‐based Practice
Author(s) -
Murphy Kristie,
Murphy Jane,
FischerCartlidge Erica
Publication year - 2020
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12470
Subject(s) - medicine , psychological intervention , amiodarone , quality management , grading (engineering) , adverse effect , intensive care medicine , patient safety , quality of evidence , health care , nursing , randomized controlled trial , surgery , atrial fibrillation , operations management , management system , civil engineering , engineering , economics , economic growth
Background Intravenous (IV) amiodarone has multiple indications including treatment of hemodynamically unstable patients and the prevention of atrial or ventricular arrhythmias after thoracic surgery. Inflammation of the vein, or phlebitis, is the most common adverse event associated with peripherally administered amiodarone. In 2017, a rise in reported phlebitis incidents was occurring at one large academic medical center. Aim This evidence‐based quality improvement initiative aimed to decrease and enhance early detection of phlebitis in patients receiving amiodarone. Methods Due to the variation in assessment and management standards, evidence‐based practice (EBP) methodology was utilized to establish a process for quality improvement. A thorough literature search was completed, identifying evidence‐based interventions to decrease phlebitis and enhance early detection. Thorough critiques of the literature and synthesis of the evidence were completed. Multidisciplinary guidelines based on the literature were created. The guidelines included interventions such as an increase in IV assessment frequency, vein selection criteria, and the utilization of a standardized grading tool for assessment. Results Phlebitis was reduced by 30%–88%. In the first 6 months post‐intervention, there was a 48% reduction in phlebitis cases. In addition, the severity of phlebitis and the quality of reporting also improved dramatically. Linking Evidence to Action This evidence‐based quality improvement process led to identifying relevant knowledge gaps in care that could be streamlined into everyday nursing practice to decrease patient harm. This paper describes an in‐depth process of how EBP helped to quickly take a clinical inquiry and adapt change based on findings from the evidence. Other organizations can utilize EBP to solve patient safety concerns using similar processes.