#1

Clinical Practice Guideline

1.       

Title: Vascular access

Date of publication: June 2021

Organization or author:  Registered Nurses’ Association of Ontario (RNAO)

Purpose: To provide all healthcare workers, mainly nurses, with evidence-based recommendations and resources to insert, assess, and maintain vascular access in all infants, pediatric, and adult populations.

Two major clinical recommendations:

-              To implement specialists for vascular access or a team to support the insertion and management of the vascular access device.

-               To provide comprehensive health teaching to the person or family/caregivers about their vascular access device.

2.         

Yes, the recommendations were based on substantial evidence.  According to the data, using Vascular access specialist teams (VASTs) could minimize issues and increase the likelihood of successful VAD insertion attempts. Most of the research focused on managing and inserting CVADs, especially PICCs. The management and insertion of PVADs became the main topics of the subsequent study.

According to evidence, comprehensive health education may lower hospital readmission rates and problems. Compared to baseline or control groups, most studies found that individuals receiving health education experienced fewer difficulties. For example, three studies showed a decrease in the incidence of occlusion and a drop in CLABSI rates. In one study, the education group experienced less clotting than the control group. One study compared hospital readmission rates for CLABSI before and after family members were taught a CVAD care class. After a month of follow-up, there were no hospital readmissions for CLABSI.

These recommendations will help me care for my patients by educating each parent about their baby’s IV access and ensuring that each IV access is maintained well to prevent infections and CLABSIs. A clinical practice guideline (CPG) is a set of recommendations for healthcare providers based on an extensive review of existing research to optimize patient care for particular conditions. A research study is an organized inquiry intended to produce new knowledge about a topic by gathering and analyzing data, frequently to test a hypothesis or assess an innovative approach.

RNAO  (2021) Vascular access https://rnao.ca/bpg/guidelines/Vascular_Access

#2

Title: Aggression Assessment Clinical Practice Guideline
Publication: 2023
Organization: Emergency Nurses Association (ENA)
Purpose: Recommended to help identify patients at risk of becoming violent based on a systematic review and critical literature analysis.
Recommendation 1: All patients should be routinely screened for aggression risk upon arrival at the emergency department. 
Recommendation 2: The use of de-escalation techniques as the first-line intervention for managing aggression. 

The clinical practice guideline (CPG) recommended by the ENA, for assessing aggression in emergency department patients is based on a systematic review and critical analysis of the literature, which suggests a high level of evidence and provides clear recommendations for using validated tools. One tool is the Broset Violence Checklist (BVC), to identify those at risk of violence (ENA, 2023). By using validated tools to identify patients at risk of violence, healthcare providers can implement appropriate interventions early, potentially preventing violent incidents (ENA, 2023). This approach enhances patient care and safety for both healthcare providers and patients.  A CPG, like the one discussed here, is a systematically developed statement to assist healthcare provider and patient decisions about appropriate healthcare for specific clinical circumstances. It is based on a comprehensive review of the current evidence and provides practical recommendations for clinical practice (Melnyk & Fineout-Overhold, 2023). A research study is a scientific investigation designed to answer specific questions about a particular aspect of healthcare, such as the effectiveness of a treatment or the accuracy of a diagnostic test (Melnyk & Fineout-Overhold, 2023). The results of multiple research studies are often used to develop a CPG.

Emergency Nurses Association (2023). Clinical practice guidlines. https://www.ena.org/enau/practice-resource-libraryLinks to an external site.

Melnyk, B. M., & Fineout-Overhold, E. (2023). Evidence-Based Practice in Nursing & Healthcare (5th ed.). Lippincott Williams & Wilkins.