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A Standard Push-Pull Protocol for Waste-Free Sampling in the Pediatric Intensive Care Unit
Clare McBride1, Suzan Miller-Hoover, James A Proudfoot
1Oregon Health and Science University, Doernbecher Children's Hospital, Portland, Oregon (Ms McBride); Rady Children's Hospital, San Diego, California (Dr Miller-Hoover); and University of California at San Diego, Altman Clinical and Translational Research Institute, San Diego, California (Mr Proudfoot). Clare McBride, BSN, RN, CCRN, is a pediatric intensive care and cardiac nurse at Oregon Health and Science University's Doernbecher Children's Hospital. She previously worked at Rady Children's Hospital in San Diego and presented this evidence-based practice project at the American Association of Critical Care Nurses' annual teaching conference. Suzan Miller-Hoover, DNP, RN, CCNS, CCRN-K, has been in the nursing profession for more than 35 years. An experienced national speaker and peer-reviewed author, Dr Miller-Hoover is passionate about evidence-based best practice and pediatrics. James A. Proudfoot, MSc, is a senior statistician at the University of California at San Diego, Altman Clinical and Translational Research Institute. He has consulted on numerous clinical trials and is a coauthor of more than 25 articles.
Reducing blood loss in pediatric intensive care units (PICUs) is crucial. A new push-pull blood sampling protocol minimizes blood loss from central venous catheters, preventing anemia and transfusions.
Area of Science:
- Pediatric Intensive Care
- Clinical Nursing
- Evidence-Based Practice
Background:
- Blood sampling in the pediatric intensive care unit (PICU) contributes significantly to patient blood loss.
- Anemia and the need for blood transfusions are risks associated with excessive blood sampling in critically ill children.
- Existing research on blood-sparing techniques like the push-pull method for central venous catheter (CVC) sampling shows variability in protocols and limited scope.
Purpose of the Study:
- To develop, implement, and evaluate a standardized push-pull blood sampling protocol for use in the PICU.
- To establish a reliable, waste-free blood sampling method to reduce iatrogenic blood loss in pediatric patients.
- To assess the safety and efficacy of a standardized push-pull technique for CVC blood sampling.
Main Methods:
- Development of a standardized evidence-based push-pull blood sampling protocol.
- Implementation of the protocol within a PICU setting.
- Evaluation of the protocol's safety, reliability, and waste reduction for CVC sampling.
Main Results:
- The standardized push-pull protocol was successfully implemented in the PICU.
- The protocol demonstrated safe and reliable performance as a waste-free blood sampling method.
- The technique effectively reduced sampling-related blood loss, mitigating risks of anemia and transfusion.
Conclusions:
- A standardized push-pull blood sampling protocol can be safely and reliably implemented in the PICU.
- This evidence-based practice project confirms the value of the push-pull method for minimizing blood loss in pediatric critical care.
- The developed protocol offers a standardized, waste-free approach to CVC blood sampling, benefiting patient outcomes.
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