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CS59
You're Draining What? A Picture Guide To Caring For Patients With Lumbar Drains
By: C. Katers, L. Boxeth, E. Bruggeman, J. Cox & H. Carrol; Mercy Hospital, Coon Rapids, MN
For further information, please contact: christine.katers@allina.com
Purpose: Neurological patients requiring lumbar drainage are assigned to the Intensive Care Unit (ICU) or the Critical Care Step-down unit in an attempt to improve and standardize evidenced-based care for this population. Because lumbar drains are a high-risk low-occurrence event on the step-down unit there was a need for an “in-time” reference tool.
Description: The Neuro-Trauma Clinical Action Team (CAT) on the Critical Care Step-down unit consists of 4 unit RNs, unit-based educator, clinical nurse specialist, and neuro-trauma nurse clinician who meet monthly for 4 hours. A goal of the group is to bring evidenced-based care to this population of patients. The team felt the most appropriate format for this tool was a 3-ring binder divided into sections. This reference includes sections for lumbar anatomy, indications for drain placement, post placement care issues, CSF collection, complications, troubleshooting, order-set, and lumbar drain guidelines by the American Association of Neuroscience Nurses. Other sections contain 4X6 color pictures using a CAT member as the patient. The photographs provide a visual reference with set-by-step instructions in the care of the patient with a lumbar drain. Some pictures include, supplies, External Drain and Monitor System (EDMS), patient positioning with head-of-bed restriction, clamping procedure during patient mobilization, leveling of drain to reference point, and changing the drainage bag.
Evaluation/Outcomes: This quick and easy visual reference was eagerly anticipated by the step-down unit staff and has become an option for use with new employee orientation. Staff appreciate the photographs and say “…a picture is worth a thousand words of description”.
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