Effectiveness of Lecture cum demonstration on Knowledge and practice regarding Intravenous cannulation among staff nurses working in selected hospital
Ms. Patricia Reddy1, Ancy Ramesh2
1Lecturer, SN College of Nursing, Hingna, Nagpur.
2Principal, Kasturba Nursing College, Sevagram, Wardha.
*Corresponding Author E-mail:
ABSTRACT:
Background: The skill of intravenous cannulation must be practiced regularly to maintain a high level of competency. This is important to gain quick and efficient intravenous access in populations when required. The insertion of intravenous catheters into peripheral veins is probably the most commonly performed invasive medical procedure in hospitals. This procedure could be difficult sometimes requiring several attempts and causing distress to patients. The high success rates of nurses in intravenous cannulation have been due to the frequent performance of intravenous cannulation Objectives: 1. To assess the existing knowledge regarding intravenous cannulation among staff nurses working in selected hospital. 2. To observe the existing practice regarding intravenous cannulation among nurses. 3. To assess the effectiveness of lecture cum demonstration regarding Intravenous cannulation among staff nurses. 4. To observe the practice of staff nurses regarding intravenous cannulation after lecture cum demonstration. 5. To correlate the knowledge and practice of staff nurses regarding intravenous cannulation .Methodology: Pre experimental one group pre test post test design. Material: Structured knowledge questionnaire and Observational checklist adopted as per WHO guidelines.Sample size: 60. Result: Among the 60 samples, according to age, 39(65%)of subjects were of 21-30 years of age, 14(23.33%) were of 31-40 years, 7(11.67%) were of 41-50 years and no subjects were above 50 yearsAccording to the educational qualification, 38(58.33%) of the subjects were with the qualification of general nurse midwives, 12(20%) were B.sc nursing, 13(21.67%) were PB.B.sc Nursing.Majority of the subjects 45% have work experience of less than 2 years, 23.33% have 3-5 years, 20% have 6-8 years and 11.67% of them have work experience of more than 8 years In relation to area of work, 26.67% of the subjects each were from the Medicine ward and surgical ward, 21.66%were from Intensive care unit and 25% of them were from Casualty/Emergency ward. post test majority of the subjects gained Knowledge regarding intravenous cannulation. 34 (56.67%) subjects had good level of Knowledge score and 23(43.33%) subjects had average level of Knowledge. None of the samples have poor level of Knowledge. the post test the findings shows that 57(95%) subjects had satisfactory level of practice whereas only 3(5%) of subjects had unsatisfactory level of practice. The mean pretest knowledge score was 15.28 and post test knowledge score was 26.58. The mean practice score 7.61 and posttest practice score was 13.76. Student’s paired ‘t’ test is applied at 5% level of significance and The calculated‘t’ value for overall knowledge score of subjects was 35.51 and the calculated ‘t’ value for overall practice score of subjects was 23.44 that statistically interpreted that the lecture cum demonstration regarding intravenous cannulation was effective in increasing the Knowledge and practice of subject. There was significant association between selected demographic variable of year of experience with their pretest knowledge, whereas other demographic variables are not significantly associated.The correlation coefficient of post test knowledge and post test practice score was ‘r’ 0.21, which is indicates a positive correlation. Conclusion: The knowledge of the target population was significantly increased, and there was significant improvement in the level of practice after receiving lecture cum demonstration regarding intravenous cannulation. The improvement in knowledge and practice was found in all subjects irrespective of their demographic variable
KEYWORDS: Peripheral venous catheter, staff nurses, Lecture cum demonstration, practice, knowledge of Intravenous cannulatio.
INTRODUCTION:
Intravenous therapy is important in the modern medicine. Millions of patients are receiving infusion therapy for life saving and for correcting the metabolic disorders through drugs, nutrition, solutions and blood products.1 Today’s hospitals rely on intravenous catheters as essential tools to access intravenous site. Although intravenous cannulization is a key procedure in almost all departments of health care, it also has its own disadvantages when not taken proper care of. These vascular access devices cause many complications like intravenous (IV) phlebitis, thrombophlebitis, catheter embolism, bleeding, nerve, tendon or ligament damage, needle stick injuries, sepsis, and etc.2
Patient safety is an emerging concern of the health care providers. The nursing professionals are faced with the challenge of providing best possible care.3 Nurses are the prime responsible personnel in the hospital for the care of the patient and they must be capable of deciding what care must be given to the patients.4 Nurses have an obligation that they and their patients are protected from the complications and hazards associated with intravenous devices. Insertion of intravenous devices is so common that it is found in all the departments of the health care setting. This procedure, being so common, there is a tendency to assume that it is routine and will not be associated with any clinical problems.5
By conducting this research the researcher felt that the study will improve evidence of clinical practice and also evaluate the current knowledge and practice of staff nurses on IV cannulation. And can even motivate the nurses for improving their knowledge and practice on IV cannulation.
Aim: to assess the effectiveness of lecture cum demonstration on knowledge and practice of staff nurses on intravenous cannulation.
BACKGROUND OF THE STUDY:
The insertion of intravenous catheters into peripheral veins is probably the most commonly performed invasive medical procedure in hospitals. This procedure could be difficult sometimes requiring several attempts and causing distress to patients.6
Pain on intravenous (IV) cannulation continues to cause considerable anxiety among the patients visiting the hospital for elective surgery. Often, it is the only unpleasant experience, especially in ambulatory surgical settings7
The magnitude of the potential for central venous catheters to cause morbidity and mortality resulting from infectious complications has been estimated in several studies. In the United States, 15 million central venous catheter days (i.e., the total number of days of exposure to central venous catheters by all patients in the selected population during the selected time period) occur in ICUs each year3. If the average rate of central venous catheter-associated blood stream infections is 5.3 per 1,000 catheter days in the ICU.8 approximately 80,000 central venous catheter-associated blood stream infections occur in ICUs each year in the United States. The attributable mortality for these blood stream infections has ranged from no increase in mortality in studies that controlled for severity of illness to 35% increase in mortality in prospective studies that did not use this control25 The attributable cost per infection is an estimated $34,508–$56,000, and the annual cost of caring for patients with central venous catheter-associated blood stream infections ranges from $296 million to $2.3 billion9
NEED OF THE STUDY:
An article was published regarding outcomes of a Continuing Education Course on Intravenous Catheter Insertion for Experienced Registered Nurses in Villanova, USA in April 2012. With an aim at improving experienced nurses' skills level of confidence, and knowledge regarding IV catheter insertion, maintenance, and infection prevention. In which many experienced nurses had lack of confidence in their intravenous (IV) catheter skills despite training with a phlebotomist and designated orientation time with the IV team. The continuing education program was conducted for 1-day which was provided for 33 experienced nurses. The findings showed that the continuing education IV course improved the knowledge and skills of experienced nurses. Improvement in knowledge was shown immediately after the course and 8 to 12 weeks later. Skills improvement with regard to infection prevention and policy adherence was evident. The study concluded that nurses' confidence levels improved after the implementation of a formal IV course. The study suggested that replication studies need to be conducted to validate the results with a larger sample size11
The ability to obtain peripheral intravenous access is an essential skill for all nurses. Although considered one of the simplest invasive procedures, mastering this potentially lifesaving intervention requires refined skills and experience.
Understanding of the nurses about the intravenous cannulation, main routes of transmission of infection and the maintenance of protocol may help reduce the incidence of infection and other IV catheter related complications.
PROBLEM STATEMENT:
Effectiveness of lecture cum demonstration on Knowledge and practice regarding Intravenous cannulation among staff nurses working in selected hospital.
OBJECTIVES OF THE STUDY:
· To assess the existing knowledge regarding intravenous cannulation among staff nurses working in selected hospital.
· To observe the existing practice regarding intravenous cannulation among nurses.
· To assess the effectiveness of lecture cum demonstration regarding Intravenous cannulation among staff nurses.
· To observe the practice of staff nurses regarding intravenous cannulation after lecture cum demonstration.
· To correlate the knowledge and practice of staff nurses regarding intravenous cannulation after lecture cum demonstration.
OPERATIONAL DEFINITION:
Assess:
According to oxford dictionary “To estimate officially the values.” In this study “it means to assess the knowledge regarding intravenous cannulation among the staff nurses.
Effectiveness:
According to oxford dictionary “An intent to produce result.” In this study it refers to the extent to which the structured teaching programme has achieved the desired effect as measured by gain in knowledge of staff nurses regarding Intravenous cannulation.
Lecture cum demonstration:
Lecture cum demonstration is a combination of the lecture and the demonstration. Their purpose is to point out relationship as they occur during a demonstration. In this study lecture cum demonstration is a method of teaching used to teach intravenous cannulation to staff nurses.
Knowledge:
According to oxford dictionary “Specific Information of an object through education and experience.
In this study it refers to the correct response of staff nurses regarding intravenous cannulation to a structured knowledge questionnaire.
Practice:
According to oxford dictionary: repeated exercise in or performance of an activity or skill so as to acquire or maintain proficiency in it.
In this study practice means, explaining an activity or training in a self reporting manner so that skills can be improved.
Staff Nurse:
According to oxford dictionary: a person trained to care for the sick or inform, especially in hospital.
In this study practice means, the nurse is a person who is qualified in the art and science of nursing and prescribe standard of education and clinical competencies.
Hospital:
According to oxford dictionary “hospital is an institution for care and treatment of sick, injured and needy.”
In this study, “hospital refers to an institution where critical patients take medical-surgical and nursing care and attention.”
Intravenous cannulation:
Intravenous cannulation is an invasive procedure in which a cannula is inserted directly into a vein for administration of intravenous fluid and medicine, blood products, blood investigation.
In this study, “Intravenous cannulation is an invasive procedure in which a cannula is inserted directly into a vein for administration of intravenous fluid and medicine, blood products, blood investigation as observed self structured teaching.”
Scope of Study:
The lecture cum demonstration on intravenous cannulation will help to improve the knowledge and practice of staff nurses regarding intravenous cannulation. Increase in Knowledge and Practice will be helpful for good clinical practices regarding intravenous cannulation.
Assumption:
1. Staff nurses may have some knowledge gap regarding intravenous cannulation.
2. Staff nurses working in the hospital may follow the appropriate practices regarding proper use of intravenous cannulation.
HYPOTHESIS:
H01: There is no significant difference between pre test and post test knowledge scores regarding intravenous cannulation among staff nurses which is measured by structured knowledge questionnaire at p<0.05 level of significance.
H02: There is no significant difference between pre test and post test practice scores regarding intravenous cannulation among staff nurses which is measured by structured observational checklist at p<0.05 level of significance.
H1: There is significant difference between pre test and post test knowledge scores regarding intravenous cannulation among staff nurses which is measured by structured knowledge questionnaire at p<0.05 level of significance.
H2: There is significant difference between pre test and post test practice scores regarding intravenous cannulation among staff nurses which is measured by structured observational checklist at p<0.05 level of significance.
Limitation:
· This study will be limited to the staff nurses working in selected hospital of Maharashtra.
· Assessment of knowledge and practice of staff nurses only once before and once after administration of lecture cum demonstration.
Conceptual Framework:
Conceptual framework based on general system model.
Conceptual framework is a representation of concepts that are assembled by virtue of their relevance to common theme. Conceptual framework provides a perspective regarding interrelated phenomena, and is loosely structured so that it provide for flexibility. Conceptual framework can serve as a spring board for generating research hypothesis.
Figure No-1 Conceptual framework based on General System Theory by Ludwing Bertanlanffy
REVIEW OF LITERATURE:
The review of literature for the study has been organized under the following headings.
1. Studies related to complications of intravenous cannulation.
2. Studies related to knowledge and practice of intravenous cannulation among staff nurses.
3. Studies related to the effectiveness of demonstration/ Planned teaching.
Research Approach:
Quantitative research approach is used in this study
Research Design:
pre experimental one group pre test and post test design
Setting of the Study:
The study was conducted in a multi- specialty hospital in Maharashtra.
Variable of the Study:
Independent Variable:
the independent variable is lecture cum demonstration on intravenous cannulation.
Dependent variable:
the dependent variable is knowledge and practice of staff nurses regarding intravenous cannulation.
Population:
Registered Staff Nurses working in hospital.
Target Population:
Staff nurses working in selected hospital.
Accessible Population:
The staff nurse meeting the inclusive criteria and who are available at the time of data collection.
Sample:
Sample consists of 60 registered staff nurses working in selected hospital and who were available at the time of data collection.
Sampling technique:
Non probability convenience sampling technique
Sample size:
Sixty registered staff nurses
Inclusion Criteria:
In this study the inclusive criteria are:-
1. Staff nurses working in a selected hospital and who is obtained registration from nursing council.
2. Staff nurses who are willing to participate in the study.
3. Staff nurses who are available during the period of data collection.
Exclusion Criteria:
In this study the exclusion criteria are:
Staff nurses who have attended similar type of training.
Tools for Data Collection:
1. Structured Knowledge questionnaire consist of 2 sections:
Section A: consist of demographic variables of the staff nurses to be participated in the study. Eg: age, professional qualification, year of experience, area of experience.
Section B: It comprises of 35 questions on Knowledge regarding intravenous cannulation.
2. Checklist for assessing the practice regarding Intravenous cannulation.
Validity:
In order to obtain content validity, the structured Questionnaire was given to 13 experts who were from the field of Medical Surgical Nursing and Child Health Nursing Department
Reliability:
The correlation and coefficient ‘r’ of the questionnaire was 0.9 which is more than 0.8 and coefficient ‘r’ of the checklist was 0.83 which is more than 0.8 hence the checklist was found to be reliable.
Pilot Study:
The pilot study was conducted from 15th to 22nd January As per laid down criteria 10 subjects were selected for pilot study using non probability convenience sampling technique.
The findings of the study were analyzed. The investigator analyzed the data using descriptive and inferential statistics. Findings indicated that lecture cum demonstration helped to increase their knowledge and improve their practices on intravenous cannulation.
Data Collection Procedure:
· Permission was obtained from concerned authority.
· The samples were approached in small groups on a daily basis.
· The data collection for the pretest was conducted in 3 consecutive days in all three shifts.
· Once the questionnaire was completed, researcher collected it back. The subject required 30 minutes duration to complete the structured questionnaire, followed by their practice were observed on the same day using checklist After the pre test lecture cum demonstration was conducted on intravenous cannulation and the procedure was demonstrated by the researcher.
· On the 7th day post test was administered in the same manner with the same questionnaire for 3 consecutive days in all three shifts
Analysis and Interpretation:
Section I
Table 1: Distribution of subjects according to their demographic variables n=60
|
Demographic Variables |
|
|
|
|
Frequency (f) |
Percentage (%) |
|
Age(YRS) |
||
|
21-30 years |
39 |
65% |
|
31-40 years |
14 |
23.33% |
|
41-50 years |
7 |
11.67% |
|
>50 years |
0 |
0% |
|
Educational Qualification |
||
|
GNM |
35 |
58.33% |
|
B.Sc Nursing |
12 |
20% |
|
Post basic B.Sc Nursing |
13 |
21.67% |
|
Msc Nursing |
0 |
0% |
|
Years of Experience |
||
|
<2years |
27 |
45% |
|
3-5years |
14 |
23.33% |
|
6-8years |
12 |
20% |
|
>8years |
7 |
11.67% |
|
Area of Work |
||
|
Medicine ward |
16 |
26.67% |
|
Surgery ward |
16 |
26.67% |
|
Icu |
13 |
21.66% |
|
Casualty/Emergency |
15 |
25% |
· Among the 60 samples, according to age, 39(65%) of subjects were of 21-30 years of age, 14(23.33%) were of 31-40 years, 7(11.67%) were of 41-50 years and no subjects were above 50 years
· According to the educational qualification, 38(58.33%) of the subjects were with the qualification of general nurse midwives, 12(20%) were B.sc nursing, 13(21.67%) were PB.B.sc Nursing.
· Majority of the subjects 45% have work experience of less than 2 years, 23.33% have 3-5 years, 20% have 6-8 years and 11.67% of them have work experience of more than 8 years
· In relation to area of work, 26.67% of the subjects each were from the Medicine ward and surgical ward, 21.66%were from Intensive care unit and 25% of them were from Casualty/Emergency ward.
Section II
Existing level of knowledge of subjects regarding intravenous cannulation.
Table 2: Distribution of subjects according to their existing level of Knowledge. n=60
|
Level of Knowledge |
Score Range |
Level of Knowledge Score |
|
|
Frequency (f) |
(%) |
||
|
Poor |
1-17(0-50%) |
50 |
83.33% |
|
Average |
18-25(50-75%) |
10 |
16.67% |
|
Good |
>25(>75%) |
0 |
0 |
|
Minimum score |
10 |
||
|
Maximum score |
20 |
||
|
Mean knowledge score |
15.28 |
||
|
Mean % Knowledge Score |
43.67 |
||
The findings of the pretest shows that 50(83.33%) of the Staff nurses had poor level of knowledge score, 10(16.67%) had average level of knowledge score and no one had good level of knowledge score regarding intravenous cannulation.
Section III
Existing level of practice of subjects regarding intravenous cannulation
Figure 2: Distribution of subjects according to their existing level of practice.
The findings shows that 59(98.33%) of the Staff nurses had unsatisfactory level of practice whereas only, 01(1.67%) subjects had satisfactory level of practice.
Section IV
Level of knowledge of subjects regarding intravenous cannulation after lecture cum demonstration
Figure 3: Distribution of subjects according to their level of Knowledge score after lecture cum demonstration.
The finding shows that in post test majority of the subjects gained Knowledge regarding intravenous cannulation. 34 (56.67%) subjects had good level of Knowledge score and 23(43.33%) subjects had average level of Knowledge. None of the samples have poor level of Knowledge.
Section V
Level of practice of subjects regarding intravenous cannulation after lecture cum demonstration.
Figure 4: Distribution of subjects according to their level of practice score after lecture cum demonstration
In the post test the findings shows that 57(95%) subjects had satisfactory level of practice whereas only 3(5%) of subjects had unsatisfactory level of practice.
Table 3: Comparison of Pre test and Posttest level of Knowledge score of subjects regarding Intravenous cannulation. n=60
|
Level of knowledge score |
Pre-test |
Post-test |
Mean % gain |
||
|
(f) |
(%) |
(f) |
(%) |
||
|
Poor |
50 |
83.33% |
0 |
0 |
- |
|
Average |
10 |
16.67% |
26 |
43.33% |
26.66% |
|
Good |
0 |
0 |
34 |
56.67% |
56.67% |
Among 60 samples, during pre test reveals majority 50(83.33%) samples were under poor level of knowledge, 10(16.67%) had average level of knowledge and none of them had good level of knowledge of intravenous cannulation. Post test assessment score indicated that 26(43.33%) of subjects were under average level and 34(56.67%) subjects had good level of knowledge. In addition mean percentage gain in Knowledge was observed in all these three levels. This indicate that the lecture cum demonstration was effective in improving the Knowledge of subjects regarding intravenous cannulation.
Table 4: Comparison of Pre test and Posttest level of Practice score of subjects regarding Intravenous cannulation. n=60
|
Practice |
Pre-test |
Post-test |
Mean % gain |
||
|
(f) |
(%) |
(f) |
(%) |
||
|
Unsatisfactory |
59 |
98.33% |
3 |
5% |
- |
|
Satisfactory |
01 |
1.67% |
57 |
95% |
93.33 |
Out of 60 samples, during pre test reveals majority 59(98.33%) samples had unsatisfactory performance whereas, 01(1.67%) samples had satisfactory performance. After intervention the post test score indicated that 3(5%) samples had unsatisfactory performance and 57(95%) samples had satisfactory performance. In addition mean percentage gain in practice was observed in all these two levels. This indicate that the lecture cum demonstration was effective in improving the practice of subjects regarding intravenous cannulation.
SECTION VI
Effectiveness of lecture cum demonstration on Knowledge regarding Intravenous cannulation among subjects working in selected hospital.
Table 5: Comparison of Mean, standard deviation, mean differences and ‘t’ value for knowledge regarding the intravenous cannulation.
|
Overall Knowledge |
Mean |
SD |
Mean Difference |
t-value |
|
Pre Test |
15.28 |
2.28 |
11.3 |
35.51 Sp<0.05 |
|
Post Test |
26.58 |
3.59 |
The calculated ‘t’ value i.e. 35.51 are much higher than the tabulated value at 5% level of significance for overall knowledge score of staff nurses which is statistically acceptable level of significance. Hence it is statistically interpreted that the lecture cum demonstration regarding intravenous cannulation was effective in increasing the Knowledge of subject.
SECTION VII
Effectiveness of lecture cum demonstration on practice regarding Intravenous cannulation among subjects working in selected hospital:
Table 6 shows the Comparison of Mean, standard deviation, mean differences and ‘t’ value for practice regarding the intravenous cannulation. n=60
|
Overall Practice |
Mean |
SD |
Mean Difference |
t-value |
|
Pre Test |
7.61 |
1.62 |
6.15 |
23.44 Sp<0.05 |
|
Post Test |
13.76 |
1.65 |
The tabulated value for n=60-1 i.e. 59 degrees of freedom was 2.00. The calculated ‘t’ value i.e. 23.44 are much higher than the tabulated value at 5% level of significance for overall knowledge practice score of staff nurses which is statistically acceptable level of significance. Hence it is statistically interpreted that the lecture cum demonstration regarding intravenous cannulation was effective in improving the practice of subject.
SECTION VIII
Association of knowledge of subjects with regard to their selected demographic variables:
The findings interpreted that the selected demographic variable of year of experience is significantly associated with their pretest knowledge, whereas age, educational qualification, area of work is not significant with their pre test knowledge score.
Association of Practices of the subjects regarding intravenous cannulation in relation to their demographic variables:
Findings interpreted that the selected demographic variable of age, educational qualification, year of experience and area of work is not significantly associated with their pretest practice score.
SECTION IX:
Correlation of knowledge and practice of subjects regarding intravenous cannulation after lecture cum demonstration.
This section deals with the correlation of post-test knowledge scores with post- practice scores of the study participants. Karl Pearson’s formula for coefficient of correlation is used for the analysis. This deals to study the mutual relation between two variables under consideration. The correlation coefficient r, always lies between -1 and +1 i.e., -1 ≤ r ≤ 1.
Table 7: Correlation of post knowledge score with post practice scores n=60
|
Score |
Mean |
SD |
Correlation Coefficient ‘r’ |
|
Post test Knowledge |
26.58 |
3.591 |
0.21 |
|
Post test Practice |
13.76 |
1.655 |
Table 12 shows that the correlation coefficient of post test knowledge and post test practice score was ‘r’ 0.21, which is a positive correlation. Hence it is statistically interpreted that there is a positive correlation between knowledge and practice of subjects regarding Intravenous cannulation.
DISCUSSION:
A similar study was conducted in Dhaka, Bangladesh 2016. The objective of the study was to find out the level of knowledge and practice on intravenous cannulization among staff nurses. Two hundred and ninety staff nurses were selected as sample from different units of hospital by using simple random sampling technique. The duration of study was six months and the instruments used for the study were self-administrated questionnaire and observational checklist. The study indicated that majority of (49.7%) subjects were having Good knowledge level followed by 25.5% had average knowledge, 21.7% had excellent knowledge and 3.1% had poor knowledge regarding purposes of Iv cannulation. About 53.8 % had found poor knowledge level followed by 39.3% had average knowledge and 5.9% had Good knowledge, whereas only 1.0% had excellent knowledge regarding indication and contraindication on IV cannulization. About 2.67% respondents had Excellent, 12% had Good, 73.33% had Average Practice and 12% had poor practice. The study concluded that half of the nurses were not knowledgeable on every aspect of IV cannulization. The study concluded that the staff nurse need to involve in identifying the care of patient with IV cannulization and safe practices.13
RECOMMENDATION:
· A similar study on a large scale including hospitals across the country can be carried out in order to estimate the level of knowledge and practice regarding intravenous cannulation for generalization of findings.
· Study can be conducted to evaluate the effectiveness of Lecture cum demonstration versus other methods of teaching on intravenous cannulation.
· An experimental study can be undertaken with large sample size to assess the level of knowledge and practice for generalization of findings.
· Study can be conducted on senior nurse’s i.e. ward in charges and supervisors on intravenous cannulation, so that they can educate their subordinates.
· Practice of intravenous cannulation can be conducted with use of IV simulation model.
· A study could be conducted to compare the effects of learning of intravenous cannulation in skills centre and clinical setting among the student nurses.
· All routine procedures conducted in the hospital can be studied in the same manner to enhance the knowledge and practice of staff Nurses.
REFERENCES:
1. Potter PA, Perry AG (2006) Fundamentals of nursing. (6th edn), West line Industrial Drive, St. Louis, USA.
2. Pettit J. Assessment of the Infant with a Peripheral Intravenous Device. Advances in Neonatal Care. 2003; 3(5): 230–40. doi:10.1053/s1536-0903(03)00171-1
3. K B. [Internet]. Patient Safety: A Shared Responsibility. 2003 [cited 2018Feb7]. Available from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No3Sept2003/Patient Safety.aspx
4. Texas board of nursing position statement synopsis 2017 [Internet]. [Cited 2018Feb7]. Available from: https://www.bon.texas.gov/pdfs/practice_dept_pdfs/position_statements_pdfs/Position Statement Summary 2017.pdf
5. Clarke HF. Using research to make a difference in clinical nursing practice. International Pediatric Conference; Canada: 2000; 1 - 4.
6. Gahlot, R., Nigam, C., Kumar, V., Yadav, G., and Anupurba, S. (2014). Catheter-related bloodstream infections. International Journal of Critical Illness and Injury Science, 4(2), 161. doi:10.4103/2229-5151.134184
7. Goudra, B., Galvin, E., Singh, P., and Lions, J. (2014). Effect of site selection on pain of intravenous cannula insertion: A prospective randomised study. Indian Journal of Anaesthesia, 58(6), 732. doi:10.4103/0019-5049.147166
8. Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med 2000; 132:391–402. https://patents.google.com/patent/US20140058330A1/en
9. Rello J, Ochagavia A, Sabanes E, et al. Evaluation of outcome of intravenous catheter-related infections in critically ill patients. Am J Respir Crit Care Med 2000; 162:1027–30.
10. (Dimick JB, Pelz RK, Consunji R, Swoboda SM, Hendrix CW, Lipsett PA. Increased resource use associated with catheter-related bloodstream infection in the surgical intensive care unit. Arch Surg 2001; 136: 229–34.).
11. Lyons MG, Kasker J. Outcomes of a continuing education course on intravenous catheter insertion for experienced registered nurses. [Internet]. Journal of continuing education in nursing. U.S. National Library of Medicine; 2012 [cited 2018Feb7]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22074216
Received on 12.02.2021 Modified on 21.03.2021
Accepted on 18.04.2021 ©A&V Publications All right reserved
Int. J. of Advances in Nur. Management. 2021; 9(3):275-282.
DOI: 10.52711/2454-2652.2021.00062