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Blueprint for Implementing New Processes in Acute Care: Rescuing Adult Patients With Intraosseous Access

Chreiman, Kristen M. MSN, CCRN; Kim, Patrick K. MD; Garbovsky, Lyudmila A. PharmD, BCPS; Schweickert, William D. MD

doi: 10.1097/JTN.0000000000000152
Innovations and Operations

The intraosseous (IO) access initiative at an urban university adult level 1 trauma center began from the need for a more expeditious vascular access route to rescue patients in extremis. The goal of this project was a multidisciplinary approach to problem solving to increase access of IO catheters to rescue patients in all care areas. The initiative became a collaborative effort between nursing, physicians, and pharmacy to embark on an acute care endeavor to standardize IO access. This is a descriptive analysis of processes to effectively develop collaborative strategies to navigate hospital systems and successfully implement multilayered initiatives. Administration should empower nurse to advance their practice to include IO for patient rescue. Intraosseous access may expedite resuscitative efforts in patients in extremis who lack venous access or where additional venous access is required for life-saving therapies. Limiting IO dwell time may facilitate timely definitive venous access. Continued education and training by offering IO skill laboratory refreshers and annual e-learning didactic is optimal for maintaining proficiency and knowledge. More research opportunities exist to determine medication safety and efficacy in adult patients in the acute care setting.

Division of Trauma, Surgical Critical Care and Emergency Surgery, The Trauma Center at Penn, Penn Presbyterian Medical Center (Ms Chreiman and Dr Kim); Department of Pharmacy, Hospital of the University of Pennsylvania (Dr Garbovsky); and Division of Pulmonary, Allergy and Critical Care, Hospital of the University of Pennsylvania (Dr Schweickert), Philadelphia, PA.

Correspondence: Kristen M. Chreiman, MSN, CCRN, The Trauma Center at Penn, Penn Presbyterian Medical Center, Division of Trauma, Surgical Critical Care and Emergency Surgery, 51N 39th Street, Medical Office Building Suite 120, Philadelphia, PA 19104 (kristen.chreiman@uphs.upenn.edu).

The authors declare no conflicts of interest.

Copyright © 2015 by the Society of Trauma Nurses.