Evaluation of Process for Passive Leg Raising (PLR)

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Table of Contents

Introduction
Rationale
Evaluating Results
Measurement of Outcomes
Strategies to Change the Project
Implications for Practice and Future Research
Conclusion
References

Introduction

Passive leg raising (PLR) is a solution to the problem of inappropriate fluid administration in intensive care units. This intervention is a part of effective fluid therapy to prevent fluid overload in hypotensive patients. The purpose of this paper is to discuss an evaluation plan with a focus on specific methods that will be used to assess the outcomes of the intervention.

Rationale

To collect the data related to the project outcomes, it is necessary to examine protocols and questionnaires that are filled in by nurses during their work with hypotensive patients and the use of PLR. The information regarding patients hemodynamic indices should be stored in two forms: soft and hard copies. Digital data will be used for statistical analysis to calculate differences in outcomes for hypotensive patients from test and control groups that can be associated with PLR. Unit managers will use these data to decide on applying PLR as a regular procedure. The proposed methods are effective to demonstrate any changes in patient outcomes that can be associated with applying PLR. This approach to collecting data is actively used while testing PLR in healthcare facilities (Cherpanath et al., 2016).

Evaluating Results

The selected outcome measures are appropriate to evaluate results regarding the set project objectives. Thus, the measures will demonstrate whether PLR will allow for predicting fluid responsiveness in hypotensive patients improving their blood pressure. Furthermore, it will be possible to determine a statistically significant difference for hypotensive patients treated with and without the intervention. The objectives regarding measuring the associated stroke volume index and providing recommendations for applying PLR will be addressed.

Measurement of Outcomes

To compare the outcomes for test and control groups, it will be important to apply such statistical tests as a chi-square test and a t-test. It will be possible to assess and prove a difference between outcomes for hypotensive patients with or without applying PLR. These approaches and tests are highly reliable and valid because of being used in many similar studies (Monnet et al., 2016; Monnet, Marik, & Teboul, 2016). This approach is evidence-based, and it is characterized by a high level of applicability because protocols used for collecting and measuring data, as well as statistical analysis tools, are described in the literature, and they are easy to use.

Strategies to Change the Project

Despite the evidence provided in sources, it is possible to expect that there will be no statistically different outcomes for patients from control and test groups. Therefore, it will be possible to change or improve the project. In this case, it is important to expand the sample for the study, focus on more measurements or hemodynamic indices, and use PLR in contrast to one more alternative intervention to test fluid responsiveness in patients.

Implications for Practice and Future Research

The findings of this project are important to indicate whether PLR can be effectively used in practice to predict fluid overload in hypotensive patients and contribute to improving blood pressure. If the project supports the effectiveness of using PLR, the hospital administration will modify the testing procedure for patients in their intensive care unit. Still, future research is required to determine procedures alternative to PLR if the study results are not statistically significant or negative.

Conclusion

The paper has presented the evaluation plan. The methods of collecting data and assessing outcomes have been discussed. Certain modifications in the project are possible if there are no positive or statistically significant outcomes associated with the research question.

References

Cherpanath, T. G., Hirsch, A., Geerts, B. F., Lagrand, W. K., Leeflang, M. M., Schultz, M. J., & Groeneveld, A. J. (2016). Predicting fluid responsiveness by passive leg raising: A systematic review and meta-analysis of 23 clinical trials. Critical Care Medicine, 44(5), 981-991.

Monnet, X., Cipriani, F., Camous, L., Sentenac, P., Dres, M., Krastinova, E.,& Teboul, J. L. (2016). The passive leg raising test to guide fluid removal in critically ill patients. Annals of Intensive Care, 6(1), 46-58.

Monnet, X., Marik, P., & Teboul, J. L. (2016). Passive leg raising for predicting fluid responsiveness: A systematic review and meta-analysis. Intensive Care Medicine, 42(12), 1935-1947.

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