Date of Conferral



Doctor of Nursing Practice (DNP)




Mary Catherine Garner


The infusion of intravenous immunoglobulin therapy in the home setting requires a critical nursing assessment and interventions aimed at managing and preventing the escalation of adverse events. Some patients experience side effects that necessitate a rapid response by field nurses, requiring standing orders for nursing administration and the availability of essential medications to alleviate symptoms in the patient's home. The clinical practice issue was that the home health agency did not have a uniform clinical practice nursing guideline to assist field nurses in providing rapid responses for managing infusion-related reactions. The purpose of this project was to develop an evidence-based clinical practice guideline using standing orders for the comprehensive management of immunoglobulin side effects in the patient's home. The practice-focused question centered on whether the use of a nursing practice guideline based on interprofessional collaboration could manage the side effects of patients in the home by decreasing the use of emergent care and improved quality of care for those patients susceptible to significant side effects. An interdisciplinary expert panel experience in IVIG l used Newman's system theory and the reach, effectiveness, adoption, implementation, maintenance framework for interprofessional collaboration in developing a clinical nursing guideline with a standing order for rating side effects. Panelists used the appraisal of guidelines, research, and evaluation II tool to appraise the evidence for the guideline. The use of clinical guideline with standing orders to address the needs of patients in the home setting may lead to positive social change by enabling more rapid management of symptoms, more effective care in the home, and improved patient outcomes

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