Click here to load reader
Upload
linda-andrews
View
215
Download
0
Embed Size (px)
Citation preview
Vol. XXVII No. 3 JOURNAL OF VASCULAR NURSING PAGE 81
www.jvascnurs.net
(2 brachial, 2 posterior tibial, 2 dorsalis pedis). Raters measured 10
individuals using one Model L250AC, 8 MHz bi-directional Sum-
mit Doppler, four straight vascular cuffs with detachable Ameri-
can Diagnostic Corporation (ADC) manometers with trigger
style air release inflators, and four ADC Model 703 palm aneroid
sphygmomanometers with detachable cuffs and trigger release
inflators with manometers.
Inter-rater reliability and intra-rater reliability were determined
through Interclass Correlation Coefficients (ICC). Intra-rater reli-
ability for determining ABI values was weak for standard cuffs
(ICC = 0.42-0.63) and moderate to strong for vascular cuffs (ICC
= 0.70-0.87). Inter-rater reliability was moderate to strong for both
cuffs (ICC = 0.83-0.96). Reliability of vascular versus standard cuffs
using mean trial values were strong (ICC = 0.77-0.88). If sphygmo-
manometers were used instead of vascular cuffs, it will take an aver-
age of two readings to obtain reliable ABI values. The results of this
study recommend the vascular cuff for reliable systolic readings.
The University of the District of Columbia Research Infra-
structure in Minority Institutions (http://www.udc.edu/rimi/)
2008 grant was the funding source.
P9
Accurate Blood Pressure Measurement Technique
Monica Kincade, RN, CVN
Peripheral Vascular Associates, San Antonio, Texas
Blood pressure measurements have been a mainstay of patient
assessment since the procedure was developed by Nokolai
Korotkoff in 1905. This poster illustrates the steps to obtain an
accurate blood pressure measurement and the implications of inac-
curate measurements. Blood pressure measurements are obtained
by providers, nurses, medical assistants, and students of healthcare
studies. The results of the measurements are utilized to monitor
current health status, determine a need for therapeutic interven-
tion, and monitor the effect of interventions. Discrepancies in
measurements can significantly impact patient health and can
tax the limited resources of healthcare institutions, clinics, and
patients. Errors in blood pressure measurements as slight as +/-
5mmHg can adversely affect the healthcare of millions by contrib-
uting to a diagnosis of hypertension in normotensive individuals;
as a result, these individuals are often exposed to pharmacologic
interventions which carry risks of adverse drug reactions as well
as a financial burden. Conversely, an individual with an elevated
blood pressure could be overlooked and untreated. This poster will
identify that a dependable protocol for blood pressure measure-
ment utilizing the standards of appropriate environment, position,
equipment, and analysis can result in an initiative to provide accu-
rate data for diagnosis and subsequent management of blood pres-
sure problems.
P10
Now That I Am An ABI Trainer - Who Do I Train?
Jo-Anna McGrath, RN, BSN
Northwestern Medical Faculty Foundation, Chicago, Illinois
Becoming an Ankle Brachial Index (ABI) trainer is an impor-
tant step in being able to demonstrate the proper technique for
doing ABIs to other healthcare professionals. The Society of Vas-
cular Nurses is taking the initiative in training vascular nurses in
this skill as part of the broader goal of educating health care pro-
viders regarding Peripheral Vascular Disease (PAD). However
some nurses may be unsure how to promote the use of an ABI
to their colleagues after taking the training sessions. I will share
how I put together a program incorporating the use of the ABI
and the proper technique in cardiovascular assessments. I will
also show some of the strategies I used to make connections
with schools and other healthcare facilities.
P11
Early Detection of Vascular Disease In An Indigent Clinic
Linda Andrews, RN, BEd, CRC
Jobst Vascular Center, Toledo, Ohio
Early detection of vascular disease in an indigent clinic can
lead to prompt treatment and management. The primary objective
of this study was to identify patients with vascular disease through
a free screening program offered at an indigent clinic. This clinic
provides primary health care services to those who are uninsured
and under-insured. Thirty-nine patients were seen by a vascular
nurse. A history and physical was obtained and the Walking Im-
pairment Questionnaire (WIQ) and Quality of Life SF-12 Survey
(SF-12) were completed. In addition, the vascular nurse measured
the Ankle-Brachial Index (ABI), provided education about both
arterial and venous diseases, and risk factor management. Of these
39 patients: 15 (38%) were referred to the vascular fellows clinic
for additional diagnostic testing and treatment. Eleven (28%) had
arterial disease with ABI<.89; 4 (10%) had venous disease as
evidence by clinical assessment of swelling, pigment changes,
and varicosities. Most were female (64%), African-American
(43%), did not complete high school (69%), and were currently
unemployed (84.6%). Mean age was 56.4 years. Sixty-four
percent had hypertension, 61% were former or current cigarette
smokers, and 76.9% were overweight with BMI >25. The WIQ
and SF-12 are currently being analyzed. Although this study is
in process, preliminary findings suggest that this approach is use-
ful in detecting disease in an indigent population and providing
subsequent follow-up care with a vascular specialist for prompt
treatment. Results of WIQ and SF-12 may further our understand-
ing of the impact of the disease on indigent patient quality of life.
P12
Behavioral Changes of Patients After ParticipationIn A Free Vascular Screening
Susan Shuman, BSN, RN
Jobst Vascular Center, Toledo, Ohio
Vascular screening are offered in many health care settings,
however, evidence supporting their benefit is lacking. Little is
known whether these screenings, vascular nurse counseling, and
educational materials have an effect on subsequent changes in
behavior. A random sample of 30 participants from the screening
registry was selected for follow-up evaluation by a vascular nurse.
These subjects were over 50 years of age, 20 women and 10 men.