Graduation Semester and Year

Summer 2024

Language

English

Document Type

Thesis

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Dr. Michelle Hampton

Abstract

Contrast extravasations pose significant risks during intravenous contrast media imaging procedures, with potential adverse outcomes ranging from minor skin irritation to severe tissue necrosis. Despite technological advancements and procedural safeguards, contrast extravasations remain a concern in healthcare settings. A comprehensive needs assessment at our institution revealed a notable incidence of contrast extravasations, highlighting the need for targeted interventions to mitigate risk and enhance patient safety. This project aims to explore the complexities of contrast extravasations, examining contributing factors, associated complications, and current prevention and management strategies to inform evidence-based practices and improve patient outcomes. This Doctor of Nursing Practice (DNP) project involved developing and implementing a prevention bundle to reduce intravenous contrast extravasations during CT scans. A comprehensive literature review identified best practices and evidence-based interventions, which included a venous vulnerability checklist, standardized catheter selection protocols, and staff education programs. The bundle was pilot tested in a controlled clinical setting, with data collected on incidence rates before and after implementation. Continuous feedback from radiology and nursing staff refined the process. Statistical analysis was conducted to assess the intervention's effectiveness. Implementing the prevention strategy reduced the incidence of contrast extravasation from thirty-two to three over eight weeks. Staff training and standardized patient assessment protocols before contrast administration decreased the incidence of extravasations which could result in fewer complications. The contrast media extravasation prevention bundle, encompassing staff education and the implementation of a venous vulnerability assessment tool, enhanced staff knowledge and reduced the incidence of contrast media extravasation, which could effectively improve patient safety and procedural outcomes in an outpatient CT radiology department.

Keywords

CT, contrast extravasations, nursing, prevention, radiology, IV contrast, prevention bundle

Disciplines

Education | Health and Medical Administration | Medical Sciences | Medical Specialties | Medicine and Health Sciences | Nursing | Social and Behavioral Sciences

Comments

I would like to express my deepest gratitude to all those who supported and guided me throughout my DNP project journey. First and foremost, I thank God for providing me with the strength, wisdom, and perseverance needed to complete this project. I extend my heartfelt thanks to my faculty advisor, Dr. Michelle Hampton, for her invaluable guidance and encouragement. I am profoundly grateful to my colleagues, whose cooperation and dedication have been vital to the success of this project. Finally, I want to thank my family and friends for their unwavering support and encouragement.

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