Location
Virtual Conference
Start Date
24-6-2022 1:30 PM
End Date
27-6-2022 2:10 PM
Keywords:
texas
Description
Background: HTG-induced acute pancreatitis (HTG-IAP) is the third most common cause of pancreatitis, accounting for approximately 14% of cases. Knowing best care practices and having protocols to care for this patient population is imperative. Nurses working on the frontline of care noticed an increase in patients with HTG-IAP being admitted to their critical care unit, thus looking for an answer to how to best care for them became crucial. Nurses sought to find an answer to what evidence-based care delivery to this patient population is available in peer-reviewed literature.
Purpose/aims: Investigators sought to answer the question, “In adults (>18 of age) with severe to very severe HTG-IAP, what evidence-based treatment in addition to continuous insulin therapy should be employed during inpatient hospitalization?”
Methods/Approach: Direct care nurses (N=9) working in a critical care unit in the southwestern United States conducted a literature review. Nurses formulated a PICOT question to guide the literature search completed on April 8, 2021. Search terms utilized were “hospitalized” AND “adult” AND “hypertriglyceridemia” AND “management” AND “insulin”. Current (<5 >years) literature search through 2021 limited to English yielded 759 peer-reviewed publications. Once screened for relevancy by title (n=17), abstracts (n=8), and full text (n=7). Three additional articles were identified through snowballing information in UpToDate and ClinicalKey on April 18, 2021, for a final sample of ten manuscripts. Levels of evidence were established through the individual ranking of articles followed by consensus using the “Quick Guide to Designs in an Evidence Hierarchy”. Synthesis of findings was facilitated using a research table for documentation of key findings and discussion.
Results: Levels of Evidence of literature were Level 1 (n=1), Level 2 (n=1), Level 4 (n=2), Level 6 (n=5), Level 7 (n=1). Outcomes were similar regarding patients with HTG-IAP who received intravenous insulin therapy (IT) and blood purification therapy (BPT). Once the treatment goal is met, the recommendation was to start oral lipid-reducing agents. In the presence of organ dysfunction, BPT was recommended. Two studies looked at implementing a fasting diet to meet HTG-IAP treatment goals.
Conclusion: Answering the question of HTG-IAP treatment with IT and/or BPT was supported with limited evidence in peer-reviewed literature using the selected search strategy. Nurses applying evidence-based management options for HTG-IAP in hospitalized patients may ensure reduced adverse outcomes. When caring for people with diabetes and other disease processes known to lead to HTG-IAP, improving frontline nurses’ application of evidence-based treatment options has the potential to improve individual health outcomes during hospitalization. Evidence-based treatment strategies must be readily accessible at the point of care delivery in easy-to-apply formats such as protocols and order sets to ensure consistency in use and applicability by the bedside nurse.
Implications for practice: Strong foundational comprehension of HTG-IAP care interventions enables care providers to advocate for evidence-based treatment interventions. Having these interventions initiated rapidly through the development of protocols and order sets ensures reliable treatment for the best outcomes. Additional research to evaluate IT, BPT, and lipid-lowering medications’ efficacy for HTG-IAP evidence-based treatment management strategies should be studied further.
Recommended Citation
Johnston, Lauren and Bennings, Rachel K., "Severe to Very Severe Hypertriglyceridemia Management" (2022). 2022 Providence Nurse Research Conference. 10.
https://digitalcommons.providence.org/prov_rn_conf_22/2022/posters/10
Severe to Very Severe Hypertriglyceridemia Management
Virtual Conference
Background: HTG-induced acute pancreatitis (HTG-IAP) is the third most common cause of pancreatitis, accounting for approximately 14% of cases. Knowing best care practices and having protocols to care for this patient population is imperative. Nurses working on the frontline of care noticed an increase in patients with HTG-IAP being admitted to their critical care unit, thus looking for an answer to how to best care for them became crucial. Nurses sought to find an answer to what evidence-based care delivery to this patient population is available in peer-reviewed literature.
Purpose/aims: Investigators sought to answer the question, “In adults (>18 of age) with severe to very severe HTG-IAP, what evidence-based treatment in addition to continuous insulin therapy should be employed during inpatient hospitalization?”
Methods/Approach: Direct care nurses (N=9) working in a critical care unit in the southwestern United States conducted a literature review. Nurses formulated a PICOT question to guide the literature search completed on April 8, 2021. Search terms utilized were “hospitalized” AND “adult” AND “hypertriglyceridemia” AND “management” AND “insulin”. Current (<5>years) literature search through 2021 limited to English yielded 759 peer-reviewed publications. Once screened for relevancy by title (n=17), abstracts (n=8), and full text (n=7). Three additional articles were identified through snowballing information in UpToDate and ClinicalKey on April 18, 2021, for a final sample of ten manuscripts. Levels of evidence were established through the individual ranking of articles followed by consensus using the “Quick Guide to Designs in an Evidence Hierarchy”. Synthesis of findings was facilitated using a research table for documentation of key findings and discussion.
Results: Levels of Evidence of literature were Level 1 (n=1), Level 2 (n=1), Level 4 (n=2), Level 6 (n=5), Level 7 (n=1). Outcomes were similar regarding patients with HTG-IAP who received intravenous insulin therapy (IT) and blood purification therapy (BPT). Once the treatment goal is met, the recommendation was to start oral lipid-reducing agents. In the presence of organ dysfunction, BPT was recommended. Two studies looked at implementing a fasting diet to meet HTG-IAP treatment goals.
Conclusion: Answering the question of HTG-IAP treatment with IT and/or BPT was supported with limited evidence in peer-reviewed literature using the selected search strategy. Nurses applying evidence-based management options for HTG-IAP in hospitalized patients may ensure reduced adverse outcomes. When caring for people with diabetes and other disease processes known to lead to HTG-IAP, improving frontline nurses’ application of evidence-based treatment options has the potential to improve individual health outcomes during hospitalization. Evidence-based treatment strategies must be readily accessible at the point of care delivery in easy-to-apply formats such as protocols and order sets to ensure consistency in use and applicability by the bedside nurse.
Implications for practice: Strong foundational comprehension of HTG-IAP care interventions enables care providers to advocate for evidence-based treatment interventions. Having these interventions initiated rapidly through the development of protocols and order sets ensures reliable treatment for the best outcomes. Additional research to evaluate IT, BPT, and lipid-lowering medications’ efficacy for HTG-IAP evidence-based treatment management strategies should be studied further.
