Ernst, Jennifer

Critically ill patients frequently require intrahospital transport (IHT) to diagnostic exams or procedures and must remain connected to life-sustaining medical lines. During IHT, the risk of tangled medical lines is unavoidable. The idea for a novel medical line securement device was inspired by a patient transport nurse due to frustrations and workflow inefficiencies managing tangled medical lines. The study aim was to explore the correlation between the utilization of a single-use securement device to manual or accidental disconnections of medical lines during IHT, and nurses’ perception of efficiency, compared to the current practice of no utilization of a securement device. In 2019, a randomized, descriptive, correlational study was conducted on 142 progressive and intensive care hospitalized patients. Study coordinators measured the number of times either IV lines or monitor cords were accidentally or manually disconnected to detangle during or after transportation and the perception of transport efficiency. Results revealed fewer manual disconnections among intervention group compared to the control. Nurses’ perception regarding the efficiency between the intervention and control group was statistically significant when the device was utilized to secure the lines and cords during transport. Nurses reported much higher satisfaction rates of transport efficiency when the device was used. This finding showed the device’s utility for improving nurse satisfaction during IHT of critically ill patients. Utilization of the medical line securement device may be generalizable across other healthcare settings and disciplines where the complexity of medical lines may exist.

The COVID-19 pandemic necessitated a triad of therapies for patients: oxygen, nutrition, and patient positioning. In the progressive care units, patients were placed in a prone position while receiving continuous enteral nutrition (EN) to optimize healing and oxygenation. The study aimed to identify the rate of aspiration pneumonia in non-ventilated COVID-19 patients placed in a prone position while receiving continuous EN. This was a single-group, descriptive retrospective study. The study was conducted at a two-time Magnet ® designated academic medical and health science center in the Southwestern United States. The sample included 97 electronic health records (EHRs) of patients diagnosed with COVID-19, receiving continuous EN, and placed in a prone position from March 15, 2020 to June 1, 2022. Data were extracted from EHRs using ICD-10 codes, including patient demographics, EN frequency, gastric tube placement, patient positioning, and incidence of aspiration pneumonia. Descriptive statistics and non-parametric tests were used. The Kruskal–Wallis rank sum test and Fisher’s exact test were employed for comparisons. Statistical significance was set at p ≤ .05. Out of 97 patients, 8 (8.25%) developed aspiration pneumonia. The majority of patients (75%) had post-pyloric feeding tubes. All patients who developed aspiration pneumonia had post-pyloric tubes. Placing COVID-19 patients in a prone position while receiving continuous EN may be a safe practice. Diligent nursing assessment is crucial to minimize aspiration risk and optimize patient outcomes.