Abstract
Poster presentation
Session G presented Tuesday, October 1,1:00-2:00 pm
Purpose: When two different phlebotomy procedures to obtain lactate values was observed, it was important to look at the evidence to clarify if this inconsistency influenced laboratory results or was it a misconception. The purpose was to find the evidence that determined if tourniquet use during the drawing of a lactate resulted in a significantly different level compared to a level drawn without a tourniquet.
Design: Staff Development project. ?,p>
Setting: Teaching 77,000 visit community hospital.
Participants/Subjects: ED staff registered nurses.
Methods: Emergency nurses are very familiar with the importance of lactate levels in determining if a patient is in severe sepsis. They are often asked to use their phlebotomy skills to obtain lactate values. Accuracy of blood lactate levels related to technique and time of blood draws has been debated. Some nurses were adamant that a tourniquet should not be used when drawing a lactate while others used a tourniquet. There exists a lack of specific procedure regarding lactate blood draws resulting in an inconsistent practice in the Emergency Department. The literature was reviewed. When looking at the level of evidence available, most were Level III. This evidence showed that there was no change with or without tourniquet use. To understand how many staff members felt tourniquet use affected the lactate value, a pre-assessment was done in the form of a pre-test. Over three days at shift huddles, 29 registered nurses were given a 5-question pretest, then listened to a presentation regarding techniques of lactate blood draws and the benefits of point-of-care testing. These nurses then completed the same five questions again in a post-test. The presenters also answered all relevant questions.
Results/Outcomes: Identical Pre and Post test results were gathered from a five question Likert scale examination. The examination included positive and negative questions to evaluate the effectiveness of the educational intervention. Nurses believed that having a tourniquet applied increased lactate levels. Post-test results indicated they believed time was a more important factor than tourniquet use, demonstrating an effective educational presentation. Initially 24% believed that drawing lactate with tourniquet was acceptable, and post intervention 76% agreed that tourniquets could be applied for lactate draws. Many agreed that the evidence showed that it’s not necessary to draw a lactate without a tourniquet. For those who were still holding on to their previous belief, the evidence showed the values were not affected if it was drawn without a tourniquet.
Implications: Findings regarding tourniquet use showed that some nursing staff hold an outdated viewpoint not based on evidence. This topic has come up on the Emergency Nurses List Serve, so there are others who are questioning the outdated practice. Correcting misconceptions can be done by looking at the evidence.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Lactate, Lactic, Tourniquet
Recommended Citation
Aridano, Nicholas N.; Garceau, Jaryd; Larrivee, Evan; and Robin, Nancy M., "Tourniquet use in obtaining a lactate value: Correcting misconceptions" (2020). General Submissions: Presenations (Oral and Poster). 146.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/146
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Tourniquet use in obtaining a lactate value: Correcting misconceptions
Austin, Texas, USA
Poster presentation
Session G presented Tuesday, October 1,1:00-2:00 pm
Purpose: When two different phlebotomy procedures to obtain lactate values was observed, it was important to look at the evidence to clarify if this inconsistency influenced laboratory results or was it a misconception. The purpose was to find the evidence that determined if tourniquet use during the drawing of a lactate resulted in a significantly different level compared to a level drawn without a tourniquet.
Design: Staff Development project. ?,p>
Setting: Teaching 77,000 visit community hospital.
Participants/Subjects: ED staff registered nurses.
Methods: Emergency nurses are very familiar with the importance of lactate levels in determining if a patient is in severe sepsis. They are often asked to use their phlebotomy skills to obtain lactate values. Accuracy of blood lactate levels related to technique and time of blood draws has been debated. Some nurses were adamant that a tourniquet should not be used when drawing a lactate while others used a tourniquet. There exists a lack of specific procedure regarding lactate blood draws resulting in an inconsistent practice in the Emergency Department. The literature was reviewed. When looking at the level of evidence available, most were Level III. This evidence showed that there was no change with or without tourniquet use. To understand how many staff members felt tourniquet use affected the lactate value, a pre-assessment was done in the form of a pre-test. Over three days at shift huddles, 29 registered nurses were given a 5-question pretest, then listened to a presentation regarding techniques of lactate blood draws and the benefits of point-of-care testing. These nurses then completed the same five questions again in a post-test. The presenters also answered all relevant questions.
Results/Outcomes: Identical Pre and Post test results were gathered from a five question Likert scale examination. The examination included positive and negative questions to evaluate the effectiveness of the educational intervention. Nurses believed that having a tourniquet applied increased lactate levels. Post-test results indicated they believed time was a more important factor than tourniquet use, demonstrating an effective educational presentation. Initially 24% believed that drawing lactate with tourniquet was acceptable, and post intervention 76% agreed that tourniquets could be applied for lactate draws. Many agreed that the evidence showed that it’s not necessary to draw a lactate without a tourniquet. For those who were still holding on to their previous belief, the evidence showed the values were not affected if it was drawn without a tourniquet.
Implications: Findings regarding tourniquet use showed that some nursing staff hold an outdated viewpoint not based on evidence. This topic has come up on the Emergency Nurses List Serve, so there are others who are questioning the outdated practice. Correcting misconceptions can be done by looking at the evidence.