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Evidence-based practice guidelines: a survey of subcutaneous dexamethasone administration
Jackie Walker1, Pauline Lane, Clare McKenzie
1NZ Institue of Community Health Care, Christchurch, New Zealand. jackview@nursemaude.org.nz
International Journal of Palliative Nursing
|October 26, 2010
Summary
Finding evidence for subcutaneous dexamethasone in palliative care is difficult. Expert opinion shows most nurses use continuous infusion for site preservation, with specific diluents and practices aligning with some guidelines.
Area of Science:
- Palliative Care Nursing
- Evidence-Based Practice
- Medication Administration
Background:
- Developing clinical practice guidelines requires robust evidence, which is often unavailable.
- Nurses require clear guidance for administering subcutaneous dexamethasone in palliative care settings.
Purpose of the Study:
- To investigate current nursing practices for subcutaneous dexamethasone administration in palliative care.
- To identify evidence gaps and expert opinions to inform guideline development.
Main Methods:
- A literature search was conducted to find existing evidence.
- A survey was used to gather expert opinions from community services regarding dexamethasone administration.
Main Results:
- Only 39% of services administered dexamethasone via bolus injection; 88% used continuous infusion, primarily for site preservation.
- Commonly used diluents included water for injection or normal saline.
- Many procedural aspects aligned with existing guidelines, with some referencing New Zealand's Waitemata District Health Board guidelines (2008).
Conclusions:
- There is a need for standardized procedural recommendations for subcutaneous dexamethasone administration by nurses.
- Further development and implementation of these recommendations are planned.
- Expert opinion and existing guidelines inform current practice, but gaps remain for comprehensive guideline development.
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