DNP Alum Publishes Scholarly Project

DNP Alum Publishes Scholarly Project

margie molloy headshotmarilyn oermann headshotLori Dugan Brien, DNP'19, published her DNP scholarly project, "Implementing a Goal-Directed Therapy Protocol for Fluid Resuscitation in the Cardiovascular Intensive Care Unit" in the AACN Advanced Critical Care. Co-authors include Marilyn H. Oermann, Thelma M. Ingles Professor of Nursing, Margory Molloy, associate professor, and Catherine Tierney, DNP alum. 

Abstract

Background

Balancing fluid administration and titration of vasoactive medications is critical to preventing postoperative complications in cardiac surgical patients.

Objective

To evaluate the impact of implementing a goal-directed therapy protocol in the cardiovascular intensive care unit on total intravenous fluids administered on the day of surgery, rates of acute kidney injury, and hospital length of stay.

Methods

A fluid resuscitation protocol using dynamic assessment of fluid responsiveness with stroke volume index was developed, and nurses were prepared for its implementation using simulation training.

Results

After implementation of the new protocol, the total amount of intravenous fluids administered on the day of surgery was significantly reduced (P = .003). There were no significant changes in hospital length of stay (P = .83) or rates of acute kidney injury (P = .86). There were significant increases in nurses’ knowledge of (P < .001) and confidence in (P < .001) fluid resuscitation and titration of vasoactive medications after simulation training.

Conclusions

Use of a fluid resuscitation protocol resulted in a reduction in the amount of intravenous fluids administered on the day of surgery. The simulation training increased nurses’ knowledge of and confidence in fluid resuscitation and titration of vasoactive medications.

Citation

Lori Dugan Brien, Marilyn H. Oermann, Margory Molloy, Catherine Tierney; Implementing a Goal-Directed Therapy Protocol for Fluid Resuscitation in the Cardiovascular Intensive Care Unit. AACN Adv Crit Care 15 December 2020; 31 (4): 364–370. doi: https://doi.org/10.4037/aacnacc2020582

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