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A Swine Burn Model for Investigating the Healing Process in Multiple Depth Burn Wounds
Published on: February 23, 2024
Implementation of a nurse-driven burn resuscitation protocol: a quality improvement project
Kyra Fahlstrom1, Cameron Boyle, Mary Beth Flynn Makic
1University of Colorado Hospital, Mail Stop F796, 12605 East 16th Avenue, Aurora, CO 80045, USA. kyra.fahlstrom@uch.edu
Critical Care Nurse
|February 5, 2013
Summary
A new nurse-driven protocol for burn resuscitation reduced fluid overload and complications. This approach improved patient outcomes by enhancing nurses
Area of Science:
- Emergency Medicine
- Critical Care Medicine
- Trauma Surgery
Background:
- Physician-ordered burn resuscitation can lead to inconsistent fluid titration and colloid administration.
- Such inconsistencies in fluid resuscitation practices contribute to overresuscitation and adverse patient outcomes.
Purpose of the Study:
- To evaluate the impact of a nurse-driven burn resuscitation protocol on fluid resuscitation and patient complications.
- To compare outcomes before and after the implementation of the protocol.
Main Methods:
- Retrospective chart reviews were conducted over a 12-month period.
- Data were collected and analyzed for fluid resuscitation and complication rates before and after protocol implementation.
Main Results:
- Before the protocol, 58% of patients experienced overresuscitation, with high rates of complications including pulmonary edema (20%), abdominal compartment syndrome (7%), and acute lung injury/acute respiratory distress syndrome (30%).
- After protocol implementation, significant improvements were observed in serum lactate levels at 24 hours (P =.007) and central venous pressure at 48 hours (P =.03).
- Notably, no cases of abdominal compartment syndrome occurred post-protocol implementation.
Conclusions:
- The nurse-driven burn resuscitation protocol enhanced nurses' recognition and management of fluid status during resuscitation.
- Implementation of the protocol led to improved patient outcomes and a reduction in severe complications like abdominal compartment syndrome.
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