Study to Identify Problems Associated with Registered Nurses, Nurse Practitioners, and Physician Assistants’ Adherence to Providing Early Hydration to Patients Admitted for Same Day Cardiac Catheterization in a Hospital Outpatient Setting
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There are over one million cardiac catheterizations (cath) done annually in the United States (Slicker et al., 2016). Cath carries possible complications of contrast induced acute kidney injury (CI-AKI), pre-procedural hydration decreases this risk (Azzalini, Spagnoli, & Ly, 2016). The study unit experiences delay initiating patient hydration prior to cath, predisposing patients to higher CI-AKI risk as majority of the patients have multiple comorbidities. The study utilized a mixed method survey to identify problems associated with adherence to patient hydration through staff perspectives, attitudes, and opinions guided by the Stetler Model of Research Utilization to Facilitate Evidenced Based Practice. The survey questionnaire integrated questions taken from tools with well-established validity and reliability; Practice Environment Scale of the Nursing Work Index, and Healthcare Team Vitality Instrument. Demographic and open ended questions were included. Twenty-nine surveys were sent using SurveyMonkey software, 72% responded; 57% responded to the qualitative questions and 52.5% viewed early hydration a problem. SPSS and Nvivo were used for analysis. There were significant differences between some variables with p value ranging from 0.000 to 0.046. Themes that emerged involve communication, staff shortage, availability of intravenous pumps, and recommendations for practice change. Themes were in synch with quantitative findings. Report on study was presented to stakeholders including recommendations for practice change; revise current protocol, staff education on hydration, meet staffing and equipment needs of the unit, unit discussions on effective communication. Future study post implemented changes is recommended and also replicating study at a multi-center level.