NK6-3 Evidence Based Practice/Research Council

NK6-3 Evidence Based Practice/Research Council

July 24, 2012 0900-1000 SFMC, Radiology Meeting Room

Members Present: Rochelle Salmore, MSN, NE-BC Clinical Manager (CHAIR);Audrey Simpson, BSN, RN Clinical Manager 7th Floor. Kelli Saucerman, MSN, RN, Director Clinical Effectiveness; Deb Kenny, PhD, RN; Deb Nussdorfer, MSN, RN, CNS-BC Magnet Coordinator; Olinda Spitzer, MSN,CNS, CCRN, ICU Educator; Candace Garko RNC MSN CNS, Clinical Manager at Birth Center; Helen Graham RN PhD. Cardiac Services; Anne Shepard, RN, Coordinator, PCH Urgent Care; Stefanie Quirk, MSN, ACNP SFMC Med- Surg, ICU Educator; Velda Baker, BSN, RN, CGRN, Staff Nurse, GI Lab; Daniele Lakin, MSN, RN, Staff Nurse, ICU; Michelle Stephens, RN, Director Value Analysis; Karen Sublett, RN, Staff Nurse; Meghan Vesely, RN, Staff Nurse, CVU; Virginia Davis, RN, CNS, Palliative Care, Alison Goldberg, RN, Staff Nurse, 7; Julie Bergsten, RN, Navigator, Cancer Center, Lynn Flood, RN, Staff Nurse, CVU, Lynn Wahl, MSN, CNS PH Med-Surg Educator Pat Moyers, Nursing Supervisor; Dan Chatelaine, CNS, RN, Pain; Peggy Plylar, MS, CRRN, CNS, RN, Spine Care. Guests: April McPike, Clinical Manager NICU, Patrick Fisher, Manager Respiratory Therapy SFMC, Ann Kjosa, VP of Nursing, Larry Benner, Manager Respiratory Therapy PH,

Agenda / Discussion / Action / Responsible
Renewal of inhaled Nitrous Oxide contract. Very expensive with seemingly little use. Current contract $16,000 per month plus hourly charge. / Michelle Stephens RN -Very little evidence to support use of nitrous oxide according to meta-analysis from Hayes report. Evidence rating Neonates C, Adults D. PH/SFMC has case studies of good outcomes on pts. particularly in past with H1N1. Patrick Fisher- Don’t use it longer than 36-48 hours in neonates. Larry Benner - Adults usually keep on until see improved values but longest use logged was 120 hours on adult. Point raised by Dr. Kenny: it is unlikely that cause of renal failure in adults is only from iNO when there are many other physical causes in these critically ill patients. Articles sent earlier to medical section chairs but no response except one email from Dr. Shrestha yesterday afternoon. / Patents will expire at end of this year. More vendors will be available.
Continue current use- is being used conservatively and for limited time.
Evidence based information provided to medical staff to encourage appropriate use.
RT validated that when used, results were positive in 95
% of cases. If no improvement seen within 20 minutes, use is discontinued. iNO is to “get the patients over the hump”, so they can proceed on to other therapies. / April McPike will follow up on use of steroids post iNO.
EBP Council will recommend to Administration to establish a subcommittee of EBP Council including Director of VA who can also represent SMAT, possibly Clinical Excellence and appropriate multidisciplinary guests when clinical use issues arise in the future. Purpose will be to review evidence in light of clinical need, clinical experience and expense. Rochelle and Michelle to write proposal