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Abe-Doi M, Murayama R, Morita K, Nakagami G, Sanada H. Predictive Factors for Infusion Site Induration After Outpatient Chemotherapy in Japan: A Secondary Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:269-275. [PMID: 38101470 DOI: 10.1016/j.anr.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE Even in the absence of extravasation, some patients develop induration at the peripheral intravenous catheterization site prior to the next day's treatment. Infusion site induration commonly affects patients who undergo repeated chemotherapy administrations. Vessel health is crucial for the continuation of chemotherapy. However, there is no effective method to prevent induration. Hence, this study aimed to investigate the factors that could cause induration for preventing its occurrence. METHODS This study was a secondary analysis of a prospective observational study. All participants were undergoing outpatient chemotherapy. Participant characteristics and related catheterization data were collected on the treatment day as baseline, and induration incidence was recorded on the subsequent treatment day. Receiver operating characteristic (ROC) analysis was performed to determine the sensitivity and specificity of cutoff points of the vein and catheter diameter ratios for distinguishing between developed induration and not developed induration. Additionally, cox regression analysis with multiple imputation was used to investigate the factors that predicted induration. RESULTS Seventy-one patients participated in the study. The cutoff point of the vein/catheter diameter ratio calculated using ROC analysis was ≥3.7. The ratio of larger-diameter veins to catheter diameter of ≥3.7 times was negatively associated with induration in both complete case analysis (HR: 0.11; p = 0.034) and multiple imputation analysis (HR: 0.12; p = .049). CONCLUSIONS Selecting the vein with 3.7 times higher diameter than the catheter diameter for the catheterization site may help prevent induration on the next treatment day.
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Affiliation(s)
- Mari Abe-Doi
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Murayama
- Research Center for Implementation Nursing Science Initiative, Research Promotion Headquarters, Fujita Health University, Aichi, Japan
| | - Kojiro Morita
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Department of Nursing, Ishikawa Prefectural Nursing University, Ishikawa, Japan.
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Duggan C, Hernon O, Dunne R, McInerney V, Walsh SR, Carr PJ. Vascular access device type for systemic anti-cancer therapies: a scoping review protocol. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S18-S22. [PMID: 37027405 DOI: 10.12968/bjon.2023.32.7.s18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Vascular access devices (VADs) are the most common invasive procedure performed in acute medicine and cancer patients undergo multiple invasive vascular access procedures. Our aim is to identify the type of evidence available regarding the best choice of VAD for cancer patients undergoing systemic anti-cancer therapy (SACT). In this article, the authors frame the scoping review protocol used, which will systematically report all published and unpublished literature around the use of VADs for the infusion of SACT in oncology. INCLUSION CRITERIA For studies to be included, they must focus on people or populations aged 18 years or older and report on vascular access in cancer patients. The concept is the variety of VAD use in cancer and reported insertion and post-insertion complications. The context surrounds the intravenous treatment of SACT whether in a cancer centre or non-cancer setting. METHODS The JBI scoping review methodology framework will guide the conduct of this scoping review. Electronic databases (CINAHL, Cochrane, Medline and Embase) will be searched. Grey literature sources and the reference lists of key studies will be reviewed to identify those appropriate for inclusion. No date limits will be used in the searches and studies will be limited to the English language. Two reviewers will independently screen all titles and abstracts and full-text studies for inclusion, and a third reviewer will arbitrate disagreements. All bibliographic data, study characteristics and indicators will be collected and charted using a data extraction tool.
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Affiliation(s)
- Caitriona Duggan
- Advanced Nurse Practitioner, Department of Oncology, Portiuncula Hospital, Galway, and School of Nursing and Midwifery, University of Galway, Ireland @caitrionadugga1
| | - Orlaith Hernon
- PhD Candidate, School of Nursing and Midwifery, University of Galway, Ireland, @OrlaithHernon
| | - Rosie Dunne
- Research Services Librarian, University of Galway Library, Ireland
| | - Veronica McInerney
- Administrative Director, HRB Clinical Research Facility, University of Galway, Ireland
| | - Stewart R Walsh
- Chair of Vascular Surgery, Department of Vascular Surgery, Galway University Hospital, Ireland
| | - Peter J Carr
- Associate Professor, School of Nursing and Midwifery, University of Galway, Ireland, @pcarriv
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Abe-Doi M, Murayama R, Komiyama C, Tateishi R, Sanada H. Effectiveness of ultrasonography for peripheral catheter insertion and catheter failure prevention in visible and palpable veins. J Vasc Access 2023; 24:14-21. [PMID: 34075824 DOI: 10.1177/11297298211022078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The increase in the success rate of peripheral intravenous catheterization against a difficult intravenous access (DIVA) using ultrasonography is reported; however, reports related to the effectiveness of using ultrasonography in increasing the success rate for visible and palpable veins is limited. Furthermore, according to a previous study, first attempt success in catheterization contributes to low catheter failure incidence. Thus, we developed a catheterization method using ultrasonography for peripheral veins including visible and palpable veins. This study investigates the effectiveness of ultrasonography use in improving the success rate of catheterization and preventing the catheter failure for peripheral veins including visible and palpable veins. METHODS Adult inpatients were recruited. Trained nurses inserted intravenous catheters using ultrasonography. Ultrasonography was used for all vein assessment, target vein selection, and puncturing (i.e. target point selection and/or needle guidance), regardless of the target vein's visibility or palpability. Catheters with over a 24-h dwelling time were followed for catheter failure incidence. RESULTS Thirty-one patients were recruited, and they required 34 catheterizations. Total number of catheterization attempts were 39. Of the peripheral veins, 51.3% (20/39) were visible and palpable, 48.7% (19/39) were DIVA. The rate of successful intravenous cannulation was 29 of 34 (85.3%) after one attempt and 4 of 34 (total 97.0%) after two attempts. The catheterization failure incidence was 3.2% (1/31) in the catheter that had an over 24-h dwelling time. CONCLUSIONS Using ultrasonography to all target veins might have contributed to higher success rates of catheterization and extremely low incidence of catheter failure based on objective findings. Selecting the vein with larger diameters and healthy tissue as puncture point and showing center of vessel lumen clearly using ultrasonography might have been contributed the results.
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Affiliation(s)
- Mari Abe-Doi
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Chieko Komiyama
- Department of Nursing, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Santos-Costa P, Paiva-Santos F, Sousa LB, Bernardes RA, Ventura F, Fearnley WD, Salgueiro-Oliveira A, Parreira P, Vieira M, Graveto J. Nurses’ Practices in the Peripheral Intravenous Catheterization of Adult Oncology Patients: A Mix-Method Study. J Pers Med 2022; 12:jpm12020151. [PMID: 35207640 PMCID: PMC8874472 DOI: 10.3390/jpm12020151] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses’ practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses’ adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.
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Affiliation(s)
- Paulo Santos-Costa
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
- Instituto Ciências da Saúde, Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
- Correspondence:
| | - Filipe Paiva-Santos
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
| | - Liliana B. Sousa
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
| | - Rafael A. Bernardes
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
| | - Filipa Ventura
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
| | | | - Anabela Salgueiro-Oliveira
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
| | - Pedro Parreira
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
| | - Margarida Vieira
- Instituto Ciências da Saúde, Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - João Graveto
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (F.P.-S.); (L.B.S.); (R.A.B.); (F.V.); (A.S.-O.); (P.P.); (J.G.)
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Abe-Doi M, Murayama R, Kawamoto A, Komiyama C, Doorenbos A, Sanada H. Damage to subcutaneous tissue at the catheterization site during chemotherapy: A prospective observational study using ultrasonography. Jpn J Nurs Sci 2021; 18:e12436. [PMID: 34350702 DOI: 10.1111/jjns.12436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/06/2021] [Accepted: 05/02/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Chemotherapy administration can affect subcutaneous tissue at the catheterization site with no macroscopic signs or subjective symptoms. Yet clinical studies about the impact of chemotherapy on tissue at the catheterization site, except for apparent extravasation cases, are limited. This study aimed to investigate subcutaneous tissue changes in nonmacroscopically damaged catheterization sites after chemotherapy administration. METHODS Participants were people with cancer receiving outpatient chemotherapy. Ultrasonographic images were used to assess the condition of subcutaneous tissues, including the vein, at the catheterization site before catheterization, immediately after chemotherapy, and on the next scheduled treatment day. Data on macroscopic inspection, palpation, and subjective symptoms were also collected and analyzed. RESULTS Data from 41 participants were analyzed. All had normal subcutaneous tissues before catheterization. After treatment, 16 (39.0%) manifested abnormalities such as subcutaneous edema, vessel wall thickening, and/or thrombosis; there was no extravasation immediately after treatment. On the next treatment day, 15 (36.6.%) showed persistent or new onset of abnormalities, including subcutaneous edema. Eight of the 15 did not exhibit any subjective symptoms or macroscopic or palpation findings. CONCLUSION After chemotherapy administration via peripheral intravenous catheters, it was found that this damage, which was difficult to detect by the conventional assessment method, persisted. Ultrasonography can provide useful information to avoid reusing damaged sites for chemotherapy administration.
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Affiliation(s)
- Mari Abe-Doi
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Atsuo Kawamoto
- Department of Diagnostic Radiology, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Chieko Komiyama
- Department of Nursing, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Ardith Doorenbos
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.,Cancer Prevention and Control Program, University of Illinois Cancer Center, Chicago, IL, USA
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Abe‐Doi M, Murayama R, Komiyama C, Sanada H. Changes in the subcutaneous tissue of catheterization site from the precatheterization state to the onset of anticancer drug-induced induration: A case report. Clin Case Rep 2021; 9:57-60. [PMID: 33505685 PMCID: PMC7813117 DOI: 10.1002/ccr3.3402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/10/2020] [Accepted: 09/20/2020] [Indexed: 11/12/2022] Open
Abstract
This case showed that anticancer drug administration induces unhealthy subcutaneous tissue (thrombus or edema) without subjective symptoms, abnormal sign by palpation, or inspection, which have an extravasation risk.
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Affiliation(s)
- Mari Abe‐Doi
- Department of Advanced Nursing TechnologyGraduate School of MedicineThe University of TokyoBunkyo‐kuJapan
| | - Ryoko Murayama
- Department of Advanced Nursing TechnologyGraduate School of MedicineThe University of TokyoBunkyo‐kuJapan
- Global Nursing Research CenterGraduate School of MedicineThe University of TokyoBunkyo‐kuJapan
| | - Chieko Komiyama
- Department of NursingThe University of Tokyo HospitalBunkyo‐kuJapan
| | - Hiromi Sanada
- Global Nursing Research CenterGraduate School of MedicineThe University of TokyoBunkyo‐kuJapan
- Department of Gerontological Nursing/Wound Care ManagementGraduate School of MedicineThe University of TokyoBunkyo‐kuJapan
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Masamoto T, Yano R. Characteristics of expert nurses' assessment of insertion sites for peripheral venous catheters in elderly adults with hard-to-find veins. Jpn J Nurs Sci 2020; 18:e12379. [PMID: 33025696 DOI: 10.1111/jjns.12379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/26/2020] [Accepted: 08/15/2020] [Indexed: 11/28/2022]
Abstract
AIM To clarify the characteristics of expert nurses' assessments when selecting an insertion site for a peripheral venous catheter (PVC). METHODS Participants were 11 competent (control group) and 13 expert nurses. Using a simulated patient, we recorded the procedures participants followed when selecting a site for a PVC insertion. The researchers interviewed the nurses after the procedure by asking targeted questions about the site selection to clarify the factors influencing that selection. During the interview, a video of that nurse's procedure was observed, and each step performed during the procedure was investigated. RESULTS We identified three assessment characteristics specific to expert nurses that influenced their PVC site selection: (a) focusing on a patient's unique characteristics and choosing the appropriate procedure for that individual; (b) avoiding complications and paying attention to the patient's daily self-care needs; and (c) carefully considering the patient's fear and fatigue during site selection and catheter insertion. Other assessments, based on the general knowledge and skill acquired by nurses in selecting a PVC site, were common to both groups: arm selection based on the patient's preference and site selection to avoid nerve injuries or complications. The control group's approach was assessed on the basis of their confidence in selecting a site for a PVC insertion. CONCLUSIONS Expert nurses assessed the patient's individual characteristics and daily self-care needs and helped mitigate the patient's anxiety. Our findings provide a basis for educational programs that share how expert nurses assess sites for a PVC insertion.
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Affiliation(s)
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Abe-Doi M, Murayama R, Tanabe H, Komiyama C, Sanada H. Evaluation of a thermosensitive liquid crystal film for catheterization site assessment immediately following chemotherapy administration: An observational study. Eur J Oncol Nurs 2020; 48:101802. [PMID: 32942231 DOI: 10.1016/j.ejon.2020.101802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/02/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Extravasation incidence is exceptionally low; however, ulceration or necrosis occurs in severe cases, possibly requiring surgical treatment. Early extravasation signs and symptoms are not always evident on treatment day, and inflammation, which leads to ulceration or necrosis, may appear several days later. Therefore, to minimize damage, identification of high-risk groups is required. This study aims to investigate the relationship between subcutaneous edema which is an early extravasation sign, and skin surface temperature using a thermosensitive liquid crystal film. METHODS Patients receiving chemotherapy through a peripheral intravenous catheter were recruited. Subcutaneous tissue around the catheterization site was observed for the presence of subcutaneous edema by ultrasonography. During chemotherapy initiation, a thermosensitive liquid crystal film was placed on the catheterization site. Color changes of the film were observed, and each case was classified according to low-temperature distribution patterns. To investigate the factors associated with temperature distribution pattern, logistic regression analysis was performed using clinically selected independent variables. RESULTS Data from 63 patients were analyzed. No obvious extravasation was observed. Film analysis revealed 34 cases of broadening low-temperature area from the vein and 23 cases of non-broadening low-temperature area from the vein. Subcutaneous edema was observed in 18 patients: 17 with broadening low-temperature area from the vein and 1 with non-broadening low-temperature area from the vein. Subcutaneous edema was positively correlated with broadening low-temperature area from the vein. CONCLUSION Catheter site skin temperature distribution pattern during chemotherapy was associated with subcutaneous edema which is the early extravasation sign immediately after chemotherapy.
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Affiliation(s)
- Mari Abe-Doi
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hidenori Tanabe
- Research and Development Center, Terumo Corporation, Ashigarakami-gun, Kanagawa, Japan
| | - Chieko Komiyama
- Department of Nursing, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
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