It was noted that Emergency Department Registered Nurses were not using the orange protective caps on every patient with a venous access catheter (IV, PICC line, Central Catheter). This was first noticed during a level 4 nursing student’s preceptor shift in the Spring Valley Emergency Department that …show more content…
The team consisted of three University of Nevada, Las Vegas level 4 nursing students. The nursing students consulted with the Emergency Department Nursing Manager to seek approval for the study. The Nursing Manager has been a Registered Nurse for 35 years with over 10 years of Emergency Department experience as a staff and charge nurse at Spring Valley Hospital. To better find the root cause of the non-compliance across the unit, the team observed and conducted a questionnaire. The observation consisted of 144 clinical hours during multiple preceptor shifts. There was also one day where the team focused on eight different rooms/beds during a day shift. The team observed if the nurses caring for these eight rooms were using the orange protective caps on every IV port. The results of this observation can be seen in Appendix A. In addition, a questionnaire was conducted with five of the staff nurses in attendance that day (See Appendix B for questionnaire). The results of this questionnaire can be seen in Appendix …show more content…
The findings of the first question on the questionnaire resulted in all 5 nurses saying they do not use the orange protective caps every time on a patient with a venous access catheter (IV) (See Appendix C for questionnaire data). The second question of the questionnaire suggested that all 5 nurses believe the use of the orange protective caps result in decreased bloodstream infections. The third question asked why nurse’s do not use the caps every time on patient’s. The team found that 80% of nurses were too busy and the remaining 20% said that they forget. It was discovered that the root cause of the problem turned out to be a unit culture of not using caps. The team found that most nurses in the Emergency Department do not worry about small issues like this, because they are busy stabilizing the patient and do not focus on the little details. It was noted that once the patient was stable, staff nurses were so focused on either sending them to another unit or discharging them. With this mentality, the orange protective caps are the least of their worries. It is also suggested that the leadership in the ED does not enforce the use of the orange protective caps, so by human nature if it is not enforced then why do