Infusion

“Intervention for Pain During Potassium Infusion”

Abstract for study:

Primary Investigator: Eve Holderman BSN, RN

Purpose: This project was aimed at identifying an effective, evidence based intervention for the relief of discomfort associated with the administration of potassium intravenously.

Synthesis of evidence: Serum potassium levels are used to identify risks associated with hypokalemia on the rhythm of the heart. Considerable resources are expended during the administration of potassium intravenously. It is common that patients report pain during the infusion; but little could be found on dealing formally with this problem, the cause of the discomfort or interventions used to relieve the discomfort experienced during this process.

Patients experiencing pain during infusions often question if the discomfort is because something’s gone wrong. This can be frightening for the patient, frustrating for the nurse, and create a barrier for the trust that what’s being done is truly in the patient’s best interest.

Since few resources were found on this topic; this meant that interventions were no more than a mixed bag of improvisation, anecdotal experience and trial and error. There was an obvious need for data to help refine and validate evidence that the interventions being used were effective and efficient.

Evidence source and rating:
A study was undertaken to identify frequency of the report of pain, commonly used interventions and the effectiveness of the measures taken to relieve discomfort. A questionnaire accompanied the doses of potassium delivered for IV administration, and over the course of six months data was collected. Findings of the questionnaire were used to develop an algorithm, which lead to the approval of a protocol; giving the nurse a creditable resource for responding to the patient’s pain.

Change in practice: The first and most important change in practice was to inform the patient of the potential for pain during the infusion. This disclosure helps to address the fear that something or someone had caused an unanticipated problem.

The development of the protocol: serves as a guideline for nurses to eliminate guesswork when taking steps to reduce pain, provides uniformity of interventions by which to measure outcomes, and show clinically that the interventions are consistent with an evidence-based practice.

Implementation Strategies: The inclusion of nurses in the process through use of a questionnaire, the use of its results in developing an algorithm and subsequent approval of a new protocol, endorses nurses to use this resource that had been thoughtfully developed with their contributions and input. This means that they can now intervene with confidence and competence in addressing this source of patient distress.

Implications for practice:
The idea of “bedside scholars” is valuable to nurses because they are stakeholders in the process. Thoughtfully assessing a problem, planning a solution and implementing an action can be beneficial to both the current situation and future situations. Projects like this should give all nurses the encouragement to help the patient and the profession by staying vigilant for and compliant with evidence-based practice.

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