Phyllis Bonham, PhD, RN, CWOCN, Medical University of South Carolina, Director, Wound Care Education Program, Clinical Assistant Professor, 99 Jonathan Lucas Street, PO Box 250160, Charleston, SC 29425, Marguerite Cappuccio, Medical University of South Carolina, Medical Center, Vascular Laboratory Nurse Supervisor, Charleston, SC 29425, Tara Hulsey, PhD, RN, Medical University of South Carolina, College of Nursing, Associate Professor, Chair Dept of Nursing, 99 Jonathan Lucas Street, PO Box 250160, Charleston, SC 29425, Carolyn Jenkins, DrPH, APRN-BC-ADM, CDE, FAAN, Medical University of South Carolina, College of Nursing, Professor, 99 Jonathan Lucas Street, PO Box 250160, Charleston, SC 29425, Teresa Kelechi, PhD, APRN-BC, CWCN, SC, Yvonne Michel, PhD, Medical University of South Carolina, College of Nursing, Associate Professor, 99 Jonathan Lucas Street, PO Box 250160, Charleston, SC 29425, and Jacob Robison, MD, Medical University of South Carolina, Medical Center, Professor, Section of Vascular Surgery, Charleston, SC 29425.
PURPOSE: LEAD affects 30% of individuals 66 years of age and older and 50% are undiagnosed. Although national guidelines have recommended ABI/TBI to detect LEAD, there are no published studies in the United States regarding the accuracy of ABI/TBI obtained by nurses using pocket Dopplers. The specific aim of this study was to determine the validity of ABI/TBI obtained by a registered nurse (RN) using a pocket Doppler compared to ABI/TBI performed by a vascular technologist (RVT) using a standard Doppler for ABI and photoplethysmography for TBI. The hypothesis was that the differences between the ABI/TBI by the RN and RVT would be no greater than 15% based on published literature that differences of 15-20% are acceptable. METHODOLOGY: A within subjects, comparative design was selected to study a convenience sample of 30 participants recruited from a hospital-based, vascular laboratory after Institutional Review Board approval and informed consent were obtained. ABI and TBI were measured by the same RN and RVT during each visit. Data were analyzed using the Bland-Altman method and regression analysis to assess the level of agreement between the RN and RVT measurements. RESULTS: The difference in the RN and RVT ABI values was within the 15% pre-established level of agreement. The difference in the TBI obtained by the RN and RVT varied by 35%-63% (right and left limbs, respectively) due to difficulty in detecting toe pressures with the pocket Doppler in several individuals with cold toes. CONCLUSIONS: The data from this study suggest that ABI, performed with a hand-held, pocket Doppler is valid and interchangeable with vascular laboratory equipment to detect LEAD. Also, the data indicate that pocket Doppler-derived TBI cannot be used interchangeably with laboratory equipment (i.e., photophlethysmograph) or used to diagnose LEAD due to difficulties in locating and hearing digital pressures, especially from cold toes.
See more of Oral Paper Presentations
See more of Oral Paper Presentations
See more of The 38th Annual WOCN Society Conference (June 24 -- 28, 2006)
