A pilot project was done to improve the quality of intravenous cannulation procedures at the pediatric high-dependency unit (PHDU) of a tertiary eye care hospital. In a nurses-led initiative, baseline data was collected, fishbone root cause analysis was done, and a custom checklist was prepared to test improvement. Plan Do Study Act (PDSA) cycles were done to test change ideas. Simple change ideas such as implementing a well-equipped designated IV trolley, hand hygiene, proper illumination, nursing assistance, reduced movement, and biomedical waste management at the point of care were implemented. The initiative improved the quality of IV procedures from a baseline of 25% to 79%. Healthcare teams used basic QI measures to rapidly improve patient quality of care at no extra cost.
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http://dx.doi.org/10.1007/s12098-024-05362-0 | DOI Listing |
Am J Emerg Med
December 2024
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Departments of Pharmacy and Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA. Electronic address:
Background: Intravenous (IV) diltiazem and metoprolol are commonly used to achieve rate control for atrial fibrillation with RVR (Afib with RVR), and are both recommended as first-line by current guidelines. While prior studies investigated the efficacy of these medications, there is little evidence available regarding the risk of adverse events (AEs) with their use.
Methods: We identified randomized controlled trials (RCT) and observational studies reporting rates of AEs following administration of IV diltiazem and metoprolol for Afib with RVR by searching PubMed, SCOPUS, EMBASE, and Cochrane Library.
Clin Imaging
January 2025
Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, United States of America. Electronic address:
Purpose: To develop an educational, interactive, ultra-high resolution, in vivo magnetic resonance (MR) neurography atlas for direct visualization of the brachial plexus and upper extremity.
Methods: A total of 16 adult volunteers without known peripheral neuropathy underwent magnetic resonance (MR) neurography of the brachial plexus and upper extremity. To improve vascular suppression, subjects received an intravenous infusion of ferumoxytol.
EClinicalMedicine
September 2024
Amsterdam UMC, University of Amsterdam, Department of Internal Medicine-Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam Public Health, the Netherlands.
Background: The use of peripheral intravenous catheters (PIVCs) contributes to healthcare-associated infections. In 2017, we implemented a multifaceted de-implementation strategy that successfully reduced the inappropriate use of catheters in seven hospitals in the Netherlands (RICAT-1 study). Five years later, we investigated the sustainability of this strategy and the contributing factors.
View Article and Find Full Text PDFLupus Sci Med
January 2025
Department of Medicine, Dvision of Rheumatology, NYU Grossman School of Medicine, New York City, New York, USA.
Objective: Traditional initial treatment regimens for lupus nephritis (LN) used oral glucocorticoids (GC) in starting doses up to 1.0 mg/kg/day prednisone equivalent with or without a preceding intravenous methylprednisolone pulse. More recent management guidelines recommend lower starting oral GC doses following intravenous pulse therapy.
View Article and Find Full Text PDFJ Infus Nurs
January 2025
Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori).
Age-related physiological changes affect various aspects of peripheral intravenous catheter (PIVC) cannulation. However, the characteristics of PIVCs, especially in older patients, have been poorly investigated. In the current cross-sectional observational study, PIVC sizes, PIVC sites, the number of attempts until successful insertion, and the degree of venodilation upon insertion among hospital inpatients aged ≥65 years were investigated, along with measurements of the vessel diameter and depth using ultrasound.
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