Abstract
Session H presented Friday, September 28, 2:30-3:30 pm
Purpose: The pain associated with IV insertion can create a stressful experience for ED patients. The objective of this study is to determine whether the use of a topical vapocoolant spray (Pain Ease) prior to IV insertion would be an effective means of reducing pain and anxiety, and improving patient satisfaction in adult ED patients.
Design: This descriptive study consisted of a comparative review of the pain and anxiety experienced by ED patients during IV insertion both with and without the use of Pain Ease prior to IV insertion.
Setting: The study was done in a suburban, 80 bed adult ED, set in a 728 bed non-profit community hospital.
Participants/Subjects: Stable ED patients requiring an IV were included in the study, with some exclusions such as unstable patients or those with fragile skin. 100 patients were randomly chosen to participate after giving consent; Pain Ease vapocoolant spray was used on half of those prior to IV insertion. Data collection was done by 16 IRB-approved ED nurses.
Methods: The same study questionnaire was used with 2 groups of consented patients, those with and without Pain-Ease applied just prior to IV insertion. The questionnaire documented both patient perceptions and nurse perceptions of the insertion. The RN documented their perception of vein quality as "Good, Fair, or Poor" using a validated vein assessment tool (VAT) and the ease of IV insertion on a scale of 1-5 (no difficulty to extremely difficult). The patient rated their levels of pain and anxiety with IV insertion on scales of 1-10. Patients who had Pain Ease used were asked if they would want the spray to be used for future IV's.
Results/Outcomes: ED RNs perceived minimal difficulty with IV insertions. On a scale of 1-10, the mean was 1.30 with Pain Ease and 1.36 without it. There was no statistical difference in the comparison of patient pain or anxiety for IV starts with or without the use of Pain Ease prior to the IV insertion. On a 1-10 scale, the mean for pain was 1.94 without Pain Ease and 2.4 with it. The comparison of patient-reported anxiety on a 1-10 scale had similar results (mean without Pain Ease 2.66 and with Pain Ease 2.52). Of patients who did have Pain Ease used prior to ED insertion, 74% would like to have it used again.
Implications: Both the RN perception of IV start difficulty & ease of insertion scored very low, perhaps due to the experience of the ED RNs, who start IV's very frequently. The actual pain and anxiety scores of the patients were very low both with and without the use of Pain Ease, again perhaps due to the skill of ED RNs. There is some benefit to the use of Pain Ease, because 74% of the patients who did have Pain Ease would request it again if they need an IV insertion. While the use of Pain Ease with all ED patients was not supported, it remains an available adjunct that can be used when needed to allay anxiety and discomfort.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Vapocoolant, IV Insertion, Pain Control
Recommended Citation
Tijerino, Martha; De Pietro, Joan; Murphy-Pascual, Bridget; Naranjo, Yvette; Poleon, Maura; Rojas, Brenda; Schram, Marcia; Selles, Yaima; Stephens-Murray, Judy; Thomas, Michelle; and Williams, Christine, "ED use of vapocoolant spray prior to IV insertion" (2019). General Submissions: Presenations (Oral and Poster). 132.
https://www.sigmarepository.org/gen_sub_presentations/2018/posters/132
Conference Name
Emergency Nursing 2018
Conference Host
Emergency Nurses Association
Conference Location
Pittsburgh, Pennsylvania, USA
Conference Year
2018
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
ED use of vapocoolant spray prior to IV insertion
Pittsburgh, Pennsylvania, USA
Session H presented Friday, September 28, 2:30-3:30 pm
Purpose: The pain associated with IV insertion can create a stressful experience for ED patients. The objective of this study is to determine whether the use of a topical vapocoolant spray (Pain Ease) prior to IV insertion would be an effective means of reducing pain and anxiety, and improving patient satisfaction in adult ED patients.
Design: This descriptive study consisted of a comparative review of the pain and anxiety experienced by ED patients during IV insertion both with and without the use of Pain Ease prior to IV insertion.
Setting: The study was done in a suburban, 80 bed adult ED, set in a 728 bed non-profit community hospital.
Participants/Subjects: Stable ED patients requiring an IV were included in the study, with some exclusions such as unstable patients or those with fragile skin. 100 patients were randomly chosen to participate after giving consent; Pain Ease vapocoolant spray was used on half of those prior to IV insertion. Data collection was done by 16 IRB-approved ED nurses.
Methods: The same study questionnaire was used with 2 groups of consented patients, those with and without Pain-Ease applied just prior to IV insertion. The questionnaire documented both patient perceptions and nurse perceptions of the insertion. The RN documented their perception of vein quality as "Good, Fair, or Poor" using a validated vein assessment tool (VAT) and the ease of IV insertion on a scale of 1-5 (no difficulty to extremely difficult). The patient rated their levels of pain and anxiety with IV insertion on scales of 1-10. Patients who had Pain Ease used were asked if they would want the spray to be used for future IV's.
Results/Outcomes: ED RNs perceived minimal difficulty with IV insertions. On a scale of 1-10, the mean was 1.30 with Pain Ease and 1.36 without it. There was no statistical difference in the comparison of patient pain or anxiety for IV starts with or without the use of Pain Ease prior to the IV insertion. On a 1-10 scale, the mean for pain was 1.94 without Pain Ease and 2.4 with it. The comparison of patient-reported anxiety on a 1-10 scale had similar results (mean without Pain Ease 2.66 and with Pain Ease 2.52). Of patients who did have Pain Ease used prior to ED insertion, 74% would like to have it used again.
Implications: Both the RN perception of IV start difficulty & ease of insertion scored very low, perhaps due to the experience of the ED RNs, who start IV's very frequently. The actual pain and anxiety scores of the patients were very low both with and without the use of Pain Ease, again perhaps due to the skill of ED RNs. There is some benefit to the use of Pain Ease, because 74% of the patients who did have Pain Ease would request it again if they need an IV insertion. While the use of Pain Ease with all ED patients was not supported, it remains an available adjunct that can be used when needed to allay anxiety and discomfort.