Generating and Integrating Evidence into Clinical Practice Improving

1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Improving Access to Follow‐up Care for Children with Attention Deficit Hyperactivity Disorder through an Interdisciplinary Treatment Team Approach, Savannah Galloway RN, Karen van Bakergem LMSW, Angela LaRosa MD Purpose: 1.To examine the efficacy of an interdisciplinary treatment team approach for attention‐deficit/hyperactivity disorder (ADHD) in children seen in tertiary specialty care 2.Improve access to care through utilization of nurse only office visits Background/Significance: The Healthcare Effectiveness Data and Information Set (HEDIS) recommends that patients started on stimulant medications attend a follow‐up appointment 30 days after initiation. The clinic was averaging 97 days before the patient was seen. In order to comply with the recommendations an interdisciplinary team was developed to provide better access to care. Methods: A prospective cohort of newly diagnosed patients with ADHD in children aged 3 through 17 evaluated using an interdisciplinary treatment team format were compared to a retrospective cohort randomly selected from the standard of care ADHD clinic evaluation. The interdisciplinary treatment team consists of a developmental pediatrician, social worker, and registered nurse with a nurse only follow‐up appointment. The standard of care ADHD clinic evaluation is a physician only visit. Evaluation: Analysis using electronic healthcare data compared the days to follow‐up visit and medication changes in ADHD patients between the two groups. Statistical significance was measured by t‐test. Results: 72 children were included in the study, 36 in each group. In the interdisciplinary treatment team format the average time to follow up was 36 days compared to 97 days in the standard of care group (p=0.02). Medication titration/changes were made in both groups (41% of the time in the standard of care group and 63% in the interdisciplinary team approach) but were not statistically significant (p= .1) No difference were found in the patient return rate between the two groups. Conclusions: The implementation of an interdisciplinary treatment team approach for the treatment of ADHD utilizing a nurse only visit improves patient access to care with days to follow up visit significantly reduced while producing the same quality of care. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Entering the Red Zone: Establishing an Interdisciplinary Specialized Medical Team for Ebola Preparedness, Jaime O'Donnell, Brandy Pockrus, BSN, RN, Sethe Wetter, ADN, RN Purpose: The overall goal was to sucessfully implement an interdisciplinary training program for a Specialized Medical for ebola preparedness. Background/Significance: Ebola and other communicable diseases have been isolated to African countries. The recent exposure of Americans to the Ebola Disease Virus has clearly demonstrated the need for proactive preparation and training for all healthcare instutitions in order to provide safe and effective care. Methods: A blended training environment was used: both didactic sessions to introduce core content and disease pathophysiologiy and progression as well as interdisciplinayr coordinated simulation in order to demonstrate competence in skills while donned in personal protective equipment (PPE). Evaluation: Knowledge transfer was demonstrated via pre and post test. The test score increased from an average of 79% to 89% following training sessions. In addition, a simulation competence was validated using a specific tool 'glow germ' to detect any possible disease exposure while participating in patietient care scenarios as well and donning and doffing of personal protective equipement. All SMT members were screened for glow germ post exercise with 100% demonstration of competency. Conclusions: All conclusions clearly indicate the succss of the SMT implemenation. As the Ebola Disease Virus and other communicable diseases are expected in the United States, all healthcare institutions must be proactive about training and validation of competency for these patients. A blended interdisciplinary learning environment fostered both knowledge transfer and sucessful demonstration of skills without disease exposure. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Care is Brain! Management of Post‐Thrombolytic Patients on a Step‐Down Unit, Leah Ramos MSN, RN, CCRN‐K, NE‐BC, Cynthia Steffen BSN, RN, CCRN, CNRN, SCRN Purpose: In this qualitative study, we examined a similar neuro‐intermediate unit (NIU) at an academic medical center that admits patients during the first twenty four hours after receiving tPA. This qualitative study sought to identify transferable qualities that could potentially allow other intermediate units to manage similar patients with positive outcomes. Background/Significance: Historically, stroke patients receiving intravenous tPA have been admitted to intensive care units for the first twenty four hours following medication administration. A prior retrospective case series at an academic medical center revealed that stroke patients who received intravenous tPA had similar outcomes when admitted to a step‐
down unit (SU) versus an ICU (Steffen, et al., 2013). Additionally, SU is more cost‐effective and patient and family satisfaction scores were high (Alexandrov, et al., 2007). Methods: Study design included analysis of both hospital and unit policies, reviews of complication rates, and reviews of unit HCAHPS scores. Key factors in allowing positive patient outcomes were identified as: specialized training of nurses, the implementation of a standardized provider paging protocol, and the existence of a specialized stroke emergency response protocol. Evaluation: Stroke patients receiving intravenous tPA admitted to an NIU had similar outcomes and complication rates compared with patients admitted to ICUs. HCAHPS scores for the NIU ranked higher than the 75th percentile for the Council of Teaching Hospitals in 9 of 10 categories. HCAHPS scores for the NIU ranks higher than average scores for the hospital in 9 of 10 categories. Conclusions: Stroke patients receiving intravenous tPA admitted to an NIU had similar outcomes compared to patients admitted to ICUs. Specialized nursing care available in a stroke unit is a key component in improving patient outcomes. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Safe Patient Handling: A Nurse's tool, Kristine Harper, Natalie Ankney Purpose: The American Nurses Association (ANA) developed national standards for Safe Patient Handling and Mobility (SPHM) in 2013. The SPHM standards set forth by the ANA directly impact the culture of safety among health care workers. Standard 4, 'Select, Install, and Maintain SPHM' and Standard 6, 'Integrate Patient Centered SPHM Assessment, Plan of Care and Use of SPHM Technology,' (ANA, 2013) were both addressed through a trial of equipment and a pilot of a mobility assessment tool. Background/Significance: According to a survery conducted by the ANA in 2011, RNs responded that one of their top 3 safety concerns was related to Musculoskeletal disorders (MDS). RNs. Also, nursing asstants are reportedly the highest MDS work related injury of any occupation. Due to the physical demands of both RNs and nursing assitants there is a need for a safer way in mobilizing patients. Methods: Four medical surgical units were selected to participate, nurses, patient care technicians (PCTs) and secretaries. A survey was sent out to discover current state perceptions of safely mobilizing patients as well as data collection on the unit level to determine how many times patients are actually being mobilized, 72 RNs, 36 PCTs and 2 secretaries responded. An intervention was performed by not only providing the units access to mobility devices; including a total lift, a mechanical sit to stand, and a non‐mechanical sit to stand; but also education and implementation of the Banner Mobility Assessment Tool (BMAT) for nurses. The BMAT not only assessed the mobility of the patient it also guided the nurse on what assistance aid they may need to use in order to safely maneuver the patient. Over the following 6 weeks data was being collected on how often patients were being mobilized. After the 6 week pilot the staff was re‐surveyed in regards to their perceptions of safely mobilizing their patients, 35 RNs, 16 PCTs and 1 secretary responded. Evaluation: Staff perceptions initially showed that they felt they were mobilizing patients safely as well as often. However, the survey post intervention showed a decrease of how safely they moved patients, most likely due to an awareness of how to assess the patient's true need of assistance. The knowledge of using mechanical lifts safely improved post intervention as expected per outcomes of the didactic and hands on training provided. Mobilization of patients increased, particularly the patients who did not get out of bed at all. The increase mobilization of patients was most likely due to not only the availability of equipment but also the knowledge that mobility is not limited to physical therapy alone; nursing is a huge component of patient mobility Conclusions: : Nursing staff had a greater awareness of the risks to their safety and embraced the use of an assessment tool and felt it improved communication between care providers and improved patient safety. Charge nurses are using the mobility levels of patients to determine patient assignments not only among RNs but also PCTs. Injuries to staff and patients decreased and patients were mobilized more frequently. Since this pilot was conducted the Medical University of South Carolina is moving forward with implementing the BMAT to all adult in‐
patient areas as well as purchasing mobility equipment accessible to every in‐patient unit. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Comparison of Arterial Lab Sampling Methods, Ann M. Benedict RNIII, MSN, CCRN Purpose: The goal of this study was to evaluate the evidence of comparative studies between closed blood conservation devices with stopcocks for lab sampling on patients requiring arterial lines for hemodynamic monitoring. The recommendation was used to inform the best practice Background/Significance: In PCICU, a three‐way stopcock was the primary means of obtaining blood from arterial catheters for lab sampling. Stopcocks have been associated with Catheter Related Blood Stream Contamination. Methods: A review of English literature included comparison of intra‐luminal and catheter tip colonization between three‐way stopcocks and closed arterial lab sampling systems. Databases included CINAHL and PubMed. The key words included: arterial lines, blood conservation device, three‐way stopcock and CR BSI. After the review was completed, a presentation was made to key stakeholders in PCICU. The stakeholders agreed that the nursing practice change to use closed arterial lab sampling systems should be supported in PCICU. The Edwards Life Sciences VAMP product representative was contacted and inventory was ordered. Initial education was provided by Edwards Life Sciences Product Educators. PCICU Superusers maintain ongoing education and the VAMP training video was placed on the PCICU intranet page as a resource. Evaluation: Three studies were found comparing the incidence of contamination between three‐way stopcock and closed lab sampling methods. The first RCT of 216 patients found statistically significant evidence (p=.03) for lower intra‐luminal contamination in the closed system. The second RCT of 130 patients found less intra luminal contamination in the closed system (7%) versus the three‐way stopcock (61%). The last RCT of 352 patients found significant reduction (p=0.0001) for reduction in both hub colonization and catheter tip colonization. Conclusions: The practice recommendation was made to use a closed arterial line lab sampling system for PCICU patients based on a strong recommendation. There was moderate quality evidence. The PCICU staff was educated on the use of the Edwards Life Science VAMP and VAMP Jr. products, which are closed arterial lab sampling products that were added to the par for the PYXIS machine. A survey was conducted one year later and there is 65.3% satisfaction with the VAMP product. The survey showed 45% of the staff would prefer the product used in NNICU for Umbilical Arterial Lines. The remaining participants were not familiar with the product. The Smiths Medical HemoDraw will be added to the par for the PYXIS machine to be used specifically for Umbilical Arterial Lines. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Gender differences in symptom clusters in patients with chronic venous disease, Teresa J. Kelechi, PhD, RN, CWCN, Mary Dooley, BS, MS, Martina Mueller, PhD Purpose: To identify gender specific differences in symptom clusters associated with chronic venous disease (CVeD) Background/Significance: There is a gap in our understanding of whether different symptom clusters exist between women and men. Individuals with CVeD experience multiple physical and psychosocial symptoms that negatively affect quality of life (QoL), however, the incidence and prevalence of CVeD is higher in women. Identification of symptom clusters could lead to improvements in symptom management and QoL for both women and men. Methods: Sample: 247 individuals with severe CVeD stages 4 (skin damage) and 5 (healed leg ulcer) who were enrolled in a randomized clinical trial to test the efficacy of a cooling intervention to prevent venous leg ulcers. Symptom clusters are defined as 3 or more concurrent symptoms that are related to each other. Instrument: VEINES‐QOL/Sym questionnaire (intraclass correlation coefficient 0.76 ‐ 0.88) administered at the enrollment visit. Statistical analyses: Exploratory factor analysis by gender of 11 items on the VEINES‐
QOL/Sym was conducted using SAS 9.4. A cut‐off value of the structure coefficients was ≥ 0.30. Evaluation: Factor loading for symptoms revealed three clusters for women and two for men. For women, four symptoms comprised a discomfort cluster (pain, 0.62; aching, 0.59; itching, 0.45; irritable, 0.53), four comprised an inflammation cluster (heavy legs, 0.70; swelling, 0.36; heat/burning sensation, 0.54; tingling, 0.49) and three comprised a night symptoms cluster (cramps, 0.50; restless legs, 0.42; throbbing, 0.42). For men, five symptoms clustered around nagging (heavy legs, 0.67; aching, 0.66; night cramps, 0.37; restless legs, 0.53; throbbing, 0.51) and four symptoms comprised a neuropathic cluster (pain, 0.39; heart/burning sensation, 0.69; tingling, 0.67; irritable, 0.52). Men were more likely to experience swelling every day (47%) compared to women (34%). Women were more likely to experience night cramps (74%) compared to men (60%). Conclusions: There are differences in symptom clusters between men and women with CVeD. Some symptoms (night cramps, restless legs, throbbing) cluster for both genders, but not within the same cluster of symptoms. Individually, some symptoms such as throbbing, night cramps and swelling are experienced more or less frequently (every day, several times a week, about once a week, less than once a week, never) between the genders. In clinical care, assessing for, and treatment of symptoms should be included in the standard of care for CVeD. In research, the relationship between symptom clusters and disease severity in men and women requires further exploration to improve quality of life. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Cardiac Cath Lab INR Policy, Angeline Davis BSN, RN, CCRN, CSRN Purpose: To demonstrate how a nurse used the evidence‐based process in order to implement a policy change to increase the INR cutoff, thus decreasing the number of patients' procedures being postponed. Background/Significance: At the Medical University of South Carolina (MUSC) Adult Cardiac Catheterization Lab, the International Normalized Ratio (INR) cut off frequently excludes patients from receiving a Left Heart Catheterization (LHC) and/or Right Heart Catheterization (RHC); thus delaying patient care. Methods: A registered nurse systematically searched PubMed and Scopus for literature related to adult heart catheterizations, INR and bleeding complications at catheter insertion sites. Each study was formally appraised by its objective, population, INR range, study type, results and study design limitations. Based on the evidence, the nurse implemented a policy change to increase the INR cutoff; engaging staff and stakeholders. Evaluation: In the literature, each patient underwent a LHC and/or a RHC. Various access sites were used; radial, femoral, internal jugular, and brachial. Some patients received heart catheterizations without interruption of anticoagulation and some received fresh frozen plasma (FFP) to decrease INR. Other patients included are end‐stage liver disease (ESLD) and patients who underwent a percutaneous coronary intervention (PCI). Each study had little to no complications with the INR ranges from 1.6‐4.5. Based on the evidence, the nurse implemented a policy change to increase the INR modestly from 1.7 to 2.0. An INR greater than 2.0 is performed for the urgent or emergent case, as deemed by the physician. Conclusions: The evidence‐based process has allowed for an increased number of heart catheterizations without compromising patient safety. There has not been an increase in bleeding site complications in the first and second quarter after the implemented change; as evidence provided by the National Cardiovascular Data Registry (NCDR), CathPCI Registry. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Trauma Nurse Specialist in the Emergency Department, Roberta Dawson, MSN, BA, RN, CEN, Howard Crowley, MSN, CCEMT‐P, Mandy Gainey, BSN Purpose: The Trauma Nurse Specialist program (TNS), at the Medical University of South Carolina (MUSC) Adult Emergency Department (ED), is a structured, nurse driven, educational process. Supported by evidence‐based practice, the TNS program utilizes qualified registered nurses whom after completing didactic and clinical training, perform as nurse leaders during trauma activations. Objectives are to maintain a standardized approach to the care of the trauma patient, effective interdisciplinary communication, and collaboration supporting best practice and educational growth. Background/Significance: The foundation of the TNS program arose from the identification of opportunities for process improvement. These areas include multidisciplinary communication, a standardized approach to nursing care, and knowledge growth. Methods: The design of the program includes 24 hours of didactic material, supporting simulation lab training scenarios, and a clinical internship. Didactic training includes lectures by current TNS nurses, emergency physician faculty, and faculty from Trauma Surgery. These lectures consist of an introduction to the trauma process, advanced pathophysiology, and disaster resource management. The clinical internship is a systematic, precepted exposure to various aspects of trauma care. Periodic examinations are used to measure progress. Evaluation: Since the implementation of the program in 2013 there has been decreased time to intervention, decreased length of stay in the ED, decreased overall length of stay, and decreased mortality for trauma patients. Conclusions: By providing advanced clinical and didactic training in the care of the trauma patient the TNS program is improving patient outcomes and staff satisfaction through effective communication, shared governance, and continual educational growth. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Improving RN Retention Rates: Implementing a Successful Mentorship Program, Dawn Terzulli MSN, RN, PCCN, Eileen Sandlin RN PCCN Purpose: Develop and implement a mentorship program on 5 East ART. The goal was to decrease RN turnover rates. Background/Significance: Retention rates are directly related to satisfaction scores and organizational costs. Knowledge base was created based on literature review of scholarly articles. Methods: The program was developed using data obtained from the literature review as a guideline. The program was then individualized to the nursing unit.The mentorship program was rolled out at a staff meeting. staff were educated with a powerpoint presentation, email, and one on one education. Evaluation: Pre‐Implementation turnover rate was 17.98%. Post implementation 4.49%. All staff surveyed post implementation reported 100% satisfaction with the program. Conclusions: Decrease in turnover rates impact staff satisfaction and organizational budget. The program is unique to 5 east and allows staff to actively participate in retention and satisfaction. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Structured family meetings incorporating view points from an interdisciplinary ICU team: Keeping the patient and family in the loop! Deidra Huckabee MSN, RN, CCRN, Janet Byrne MSN, RN, Brian Conner PhD, RN Purpose: Research demonstrates the importance of organized family meetings in the ICU to aid in promoting communication, understanding of the patient's condition and increasing satisfaction. Background/Significance: The purpose of this pilot study is to: 1. Determine if structured meetings with the interdisciplinary ICU team improves the patient/family experience. 2. Identify the most appropriate decision maker in the patient/family dynamic who will best serve the patient's interest. This pilot project was conducted in the Medical Intensive Care Unit in an academic hospital. Methods: This was a prospective study that utilized a convenience sample of patients admitted over 5 month's period to the MICU that met the following inclusion criteria: ICU admissions after hospital stay greater than 10 days. Multisystem organ failure Stage IV malignancy Status post cardiac arrest Intracranial hemorrhage involving mechanical ventilation. The interdisciplinary team met twice weekly at the bedside to discuss patient/family needs including the need for a more detailed meeting with the physician. Family was included in these rounds if they were available and wanted to participate. Prior to the meeting, a brochure was given to the designated spokesperson for the patient/family. This brochure introduces the attending physicians and suggests questions the patient/family may want to ask. It was then determine if a more private meeting was needed. The nurse/MD notified the primary spokesperson so they could clearly articulate the patient's wishes during these sessions.The results of the meeting were documented in the physician notes to facilitate communication with other caregivers. Evaluation: During the 5 month period of the pilot study, a total of 82 MICU patients completed the patient satisfaction survey. Patients reported a 90.76% satisfaction rate with completion of the survey. During the same time period, a total of 76 patients that received care in the comparison ICU completed the survey and reported a 93% satisfaction rate for the same item. A two‐tailed t‐test was used to compare the means and demonstrated that there was not a statistically significant difference in the patient satisfaction rates between the two ICU (p=0.4057; 95% CI= ‐15.2158 to 6.9308). Conclusions: The results of this pilot study did not demonstrate a statistically significant improvement in patient satisfaction. These findings may be the result of: Small sample sizes and relatively short period of time evaluated. There was also difficulty in tracking family meetings due to the transition to a new charting system the same time period. Family members other than designated spokesperson requesting to meet with the team More specific criteria are needed for selecting patients/families, conducting the family meetings, and documenting the results. Future studies will require a longer period of time to obtain an adequate sample size to determine if the intervention has the desired impact. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Kidney Transplant Caregivers: Improving coping in the immediate post‐operative period, Mary Shearer, Debra Cassidy, Katherine Juergens Purpose: An interdisciplinary approach to literature review using PICO. A literature review will be completed to determine if evidence is available to support introduction of nutrition services in the immediate post‐operative period as a method of improving caregiver coping. Background/Significance: Caregivers are a mandatory part of the care plan after a kidney transplant. Patients that do not live within a 30 mile radius of this South Carolina hospital are required to stay at a local address, away from their support systems and infrastructure. Displacement may increase caregiver stress due to their increased responsibilities; poor nutrition availability and cost and increased financial burden. By providing free, well‐balanced meals through Meals on Wheels caregiver coping may be improved. Methods: The literature search began with the goal of finding ways to improve caregiver coping. All search terms were entered into Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Database of Systematic Reviews, and PubMed. The terms searched were post‐surgical, meals on wheels, caregiver, nutrition, kidney transplant, coping, stress, availability of food, weight gain and wound healing. Limiting factors were time frame within the last ten years and only English language, which produced over 50 results. The results were then narrowed by reading either the title or abstract looking only for caregiver coping, food availability and kidney transplant. Seven articles were selected for more in depth review with exclusion criteria of opinion pieces, recipient health and adult population. The review was further reduced to five articles by limiting focus on caregiver rather than patient. Evaluation: • Unexpectedly, weight gain is not affected by food availability, but outcomes are affected by nutritional content of food (Bloodworth, 2014). • Caregiver stress and coping should be factored into the care in the immediate post‐transplant period. Caregiver burden is increased, especially when they are away from local support systems (Goetzniger, 2012). •
Pre and post‐transplant nutrition education improves outcomes post‐transplant (McCarthy, 2006 & Veroux, 2013). • High levels of caregiver strain are linked to pre and post‐transplant periods (Rodrigue, 2010). Conclusions: Nutrition focus is important throughout the whole transplant event and would be beneficial to start at listing. Assistance through community partnerships, namely Meals on Wheels, can offer free nutrition services post‐transplant reducing part of the financial and psychological burden on the caregiver. This single intervention improves nutrition status of each patient and may lead to a decrease in caregiver burden, ultimately contributing to improved caregiver coping. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Examining the risk factors associated with inadvertent hypothermia, Alison Partridge RN, MSN, CPAN, Christina Crook RN‐BC, Purpose: The purpose of this study was to determine if age, type of surgery, length of surgery, gender or BMI are associated with an increased risk of inadvertent hypothermia. Background/Significance: Inadvertent hypothermia is defined as hypothermia in the postoperative period below 36 degrees Celsius (96.8 F). Inadvertent hypothermia puts a patient at risk for numerous complications including bleeding, infection and arrhythmias. ASPAN (Association of Perianesthesia Nurses) guidelines recommend preoperative warming utilizing forced air warmers. Fluid warming is a common practice in the OR for subsequent bags of fluid (Assosiation of periOperative Registered Nurses‐ AORN standards). There are many risk factors associated with inadvertent hypothermia such as age, gender, BMI, and length of procedure. However, none of these risk factors are supported with strong evidence. Methods: Design: Secondary analysis of a prospective descriptive study data, comparing 3 groups for rate/s of inadvertent postoperative hypothermia. Sample: All patients that met inclusion criteria for 3 consecutive months (October, November, December). n=684 Measurement: Chart review was completed to collect age, procedure type, length of procedure, BMI and gender. Patient temperature was the measure of interest. Temperature was collected according to standard of practice for pre‐intra‐post operative care. Evaluation: Preliminary results show relationship between BMI and inadvertent hypothermia rates. Conclusions: Results suggest that patients with increased risk should receive more interventions preoperatively to prevent postoperative hypothermia. A preoperative warming protocol is suggested in order to provide those patients with increased risk with more active warming interventions pre‐operatively and intraoperatively in order to prevent inadvertent hypothermia. 1st Annual MUSC Health Evidence‐Based Practice and Nursing Research Conference: Generating and Integrating Evidence into Clinical Practice Using Evidence‐Based Nursing Research to Change Practice: Photosensitivity in Photodynamic Therapy, Carolyn C. Cavanaugh, RN, CRNO, Elizabeth A. Crabtree, MPH, Purpose: Use evidence‐based nursing research methods to critically evaluate evidence on the length of time the adult is photosensitive after Photodynamic Therapy (PDT) to reduce 'out of bright light' to 2 days from 5 days. Background/Significance: Verteporfin is a light activated drug used in photodynamic therapy to reduce the risk of vision loss. Photodynamic therapy has been approved to treat patients with subfoveal choroidal neovascularization in age‐related macular degeneration, pathological myopia, and ocular histoplasmosis. More currently, the FDA has approved use under the Orphan Drug Act for chronic central serous chorioretinopathy. A side effect of verteporfin is photosensitivity of the skin. Exposure to direct sunlight or any bright lights should be avoided after treatment. Methods: Strategic searches of databases for literature relating to time and duration of photosensitivity after infusion of verteporfin. Critical evaluation of evidence using the GRADE criteria. Evaluation: Evidence and expert opinion indicate photosensitivity is short lived. Bright light should be avoided for 24‐48 hours after verteporfin infusion, except in cases of extravasation, swelling or discoloration. Conclusions: Evidence supports the safety and efficacy of change to 48 hour photosensitivity time post PDT. Patient education instructions were modified to reflect best available evidence