respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines.
1st peer resp
Ruth Ann Greco-Gauvreau
The facility I work in is a Level III NICU, which means we can care for infants at 22 weeks’ gestation and 350 grams. Taking care of such small infants has its challenges. One of these is preventing intraventricular hemorrhage (IVH). One of the protocols we use is called a neuro-protection bundle. This care includes maintaining the infant in an elevated, midline supine position for the first seventy-two hours, administering antenatal steroids prior to delivery, giving the mother magnesium sulfate for neuroprotection, and minimizing rapid fluid infusion. We also perform serial head ultrasounds to monitor the infants’ progress, usually on days three and seven of life, and weekly follow-ups to check progression. Of course, preventing preterm delivery is the best method to avoid IVH. “Nursing care plays a critical role in reducing the progression and severity of GMH–
IVH. Nursing interventions can be implemented by the care team for prevention and protection against GMH–
IVH. The infant’s
head should be maintained in a midline position with the
head slightly elevated to reduce intracranial pressure and prevent obstruction of the jugular veins. Meta-anaylses support that maintaining the infant’s
head in a midline position might reduce infant mortality” (Langley, 2022).Skilled nursing care is essential to preventing damage, especially due to IVH.
The Galen library was very easy to use. I searched head protocol for neonatology and intraventricular hemorrhage. The article I found does support our current practice.
Langley, E. A., Blake, S. M., & Coe, K. L. (2022). Recent Review of Germinal Matrix Hemorrhage–Intraventricular Hemorrhage in Preterm Infants.
2nd peer resp
The intervention that I use daily at work is scanning medications at the bedside before giving them to my patient. I just discussed this with my orientee at work when we were discussing best and safe practices. There is always a way around things such as manually entering barcodes and saying that you gave a medication without scanning, but that is not the safest way. The case study I found discusses that in detail, “Closed-loop medication system: Leveraging Technology to Elevate Safety.” In this study, the authors discuss how introducing a scanning-based medication administration system reduced errors by 2% points per month over a 5-year period. This method has the nurse scanning the patient’s personal wrist band then scanning the medications ordered (Burkoski et al., 2019). They also discussed how a closed-loop medication system reduced errors by 10% per month. The use of a closed loop system is the doctors inputting their own orders into the computer rather than a verbal or written order (Burkoski et al., 2019). This study showed me that all the tedious scans do reduce errors, and having doctors input their orders is a crucial part of reducing medication errors.
To find this article, I went to the library website. I opened EBSCO host, which has been my favorite database to search for articles since my ADN 5 years ago. I changed the settings to only find studies, articles, evidence-based practice, and nursing journals. I also ensured the settings had a year limit to meet the rubric. It’s not needed, but I would like to make the first author a nurse when searching. To me, that makes the articles more nursing related and less administrative or for doctors. I searched for medication administration, and then in my second line, I added error reduction, and this was the first article to pop up. I found it easy to search for an article relevant, and I also have had practice in navigating these databases and knew how to mess with the settings.
Burkoski, V., Yoon, J., Solomon, S., Hall, T. N. T., Karas, A. B., Jarrett, S. R., & Collins, B. E. (2019). Closed-loop medication system: Leveraging technology to Elevate Safety. Canadian Journal of Nursing Leadership, 32(SP), 16–28.