Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

Abstract

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolyte disturbances control among critically ill patients.

Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolyte loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.

Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.

Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvement in the effectiveness and timeliness of electrolyte replacement.