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Hastings A, Barton A. Rapid haemostasis to achieve dressing longevity: evaluation trial results using StatSeal catheter exit site protection. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S8-S14. [PMID: 39023031 DOI: 10.12968/bjon.2024.0164] [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: 07/20/2024]
Abstract
Peripherally inserted central catheters (PICCs) are vital in delivering intravenous therapy. Despite their advantages, PICCs can lead to complications such as catheter exit site bleeding, which can cause patient distress and increase infection risk. This study evaluated the efficacy of StatSeal, a topical haemostatic device, in managing PICC exit site bleeding. StatSeal uses a hydrophilic polymer and potassium ferrate to form a seal, reducing access site bleeding and minimising dressing changes. For this study, Patients were recruited at Frimley Health NHS Foundation Trust; the trial involved 177 patients with StatSeal, and shows that 99% did not require additional dressing changes within the standard 7-day period. The findings demonstrate StatSeal's effectiveness in improving patient outcomes by reducing exit site bleeding and associated complications, enhancing the efficiency of vascular access maintenance and potentially lowering associated healthcare costs. The trial emphasises the importance of innovative solutions such as StatSeal to advance PICC care and improve patient experience.
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Affiliation(s)
- Angela Hastings
- Clinical Nurse Specialist, Vascular access and IV therapy, Frimley Health NHS Foundation Trust, Frimley, angela
| | - Andrew Barton
- Nurse Consultant, IV Therapy and Vascular Access, Frimley Health NHS Foundation Trust, Frimley, and Chair, National Infusion and Vascular Access Society
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Li J, Hu Z, Luo M, Wu Z, Dou X, Wang Z, Yu S, Xiao L, Qiu J, Yu S, Chen M, Lu S, Su B, Cheng L, Fan Y, Qin HY. Safety and effectiveness of tunneled peripherally inserted central catheters versus conventional PICC in adult cancer patients. Eur Radiol 2024:10.1007/s00330-024-10852-y. [PMID: 38940828 DOI: 10.1007/s00330-024-10852-y] [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: 03/14/2024] [Revised: 05/05/2024] [Accepted: 06/05/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This study aimed to compare the safety and effectiveness of tunneled peripherally inserted central catheters (T-PICC) vs. conventional PICCs (C-PICC) in adult cancer patients. METHODS A multicentre randomized controlled trial was conducted between April 2021 and January 2022 in seven hospitals in China. 564 participants were randomly assigned to T-PICC or C-PICC. These data were collected and compared: the baseline characteristics and catheterization-related characteristics, periprocedural complications, and long-term complications. RESULTS Five-hundred fifty-three participants (aged, 52.6 ± 12.3 years; female, 39.1%) were ultimately analyzed. No significant differences in periprocedural complications were found between the T-PICC and C-PICC groups (all p > 0.05). Compared with C-PICC, T-PICC significantly reduced the incidence of long-term complications (26.4% vs. 39.9%, p < 0.001). Specifically, reduced complications were found in central line-associated bloodstream infection (1.8% vs. 5.1%, p = 0.04), thrombosis (1.1% vs. 4.0%, p = 0.03), catheter dislodgement (4.7% vs. 10.1%, p = 0.01), non-infectious oozing (17.3% vs. 28.6%, p = 0.002), local infection (3.6% vs. 7.6%, p = 0.04), skin irritation (6.1% vs. 10.9%, p = 0.046), and reduced unplanned catheter removal (2.2% vs. 7.2%, p = 0.005). No significant differences were found between T-PICC and C-PICC regarding catheter occlusion (6.5% vs. 5.8%, p = 0.73) or skin damage (2.2% vs. 2.9%, p = 0.58). CONCLUSION T-PICC is safe and effectively reduces long-term complications. CLINICAL RELEVANCE STATEMENT The tunneled technique is effective in reducing PICC-related long-term complications. Thus, it is recommended for cancer patients at high risk of PICC-related complications. TRIAL REGISTRATION The registration number on https://www.chictr.org.cn/ is ChiCTR2100044632. The name of the trial registry is "A multicenter randomized controlled study of clinical use of tunneled vs. non-tunneled PICC". KEY POINTS Cather-related complications are associated with the technique of catheterization. Compared with conventional PICC, tunneled PICC reduced catheter-related long-term complications. Tunneled PICC placement provides an alternative catheterization method for cancer patients.
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Affiliation(s)
- Jia Li
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Zeyin Hu
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Mengna Luo
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Zhenming Wu
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Xinman Dou
- Lanzhou University Second Hospital, Lanzhou, 730030, China
| | - Zhiying Wang
- Hainan Cancer Prevention and Treatment Center, Hankou, 570100, China
| | - Shuang Yu
- Hainan Cancer Prevention and Treatment Center, Hankou, 570100, China
| | - Liping Xiao
- Longyan First Hospital, Longyan, 364000, China
| | - Jinhua Qiu
- Longyan First Hospital, Longyan, 364000, China
| | - Shuxian Yu
- Cancer Hospital of Shantou University Medical College, Shantou, 515000, China
| | - Mengyun Chen
- Jieyang People's Hospital, Jieyang, 522000, China
| | - Suxiang Lu
- Jieyang People's Hospital, Jieyang, 522000, China
| | - Binglian Su
- Gaozhou People's Hospital, Gaozhou, 525200, China
| | - Li Cheng
- Gaozhou People's Hospital, Gaozhou, 525200, China
| | - Yuying Fan
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
| | - Hui-Ying Qin
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
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Curtis K, Gough K, Krishnasamy M, Tarasenko E, Hill G, Keogh S. Central venous access device terminologies, complications, and reason for removal in oncology: a scoping review. BMC Cancer 2024; 24:498. [PMID: 38641574 PMCID: PMC11027380 DOI: 10.1186/s12885-024-12099-8] [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: 09/27/2023] [Accepted: 03/08/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Lack of agreed terminology and definitions in healthcare compromises communication, patient safety, optimal management of adverse events, and research progress. The purpose of this scoping review was to understand the terminologies used to describe central venous access devices (CVADs), associated complications and reasons for premature removal in people undergoing cancer treatment. It also sought to identify the definitional sources for complications and premature removal reasons. The objective was to map language and descriptions used and to explore opportunities for standardisation. METHODS A systematic search of MedLine, PubMed, Cochrane, CINAHL Complete and Embase databases was performed. Eligibility criteria included, but were not limited to, adult patients with cancer, and studies published between 2017 and 2022. Articles were screened and data extracted in Covidence. Data charting included study characteristics and detailed information on CVADs including terminologies and definitional sources for complications and premature removal reasons. Descriptive statistics, tables and bar graphs were used to summarise charted data. RESULTS From a total of 2363 potentially eligible studies, 292 were included in the review. Most were observational studies (n = 174/60%). A total of 213 unique descriptors were used to refer to CVADs, with all reasons for premature CVAD removal defined in 84 (44%) of the 193 studies only, and complications defined in 56 (57%) of the 292 studies. Where available, definitions were author-derived and/or from national resources and/or other published studies. CONCLUSION Substantial variation in CVAD terminology and a lack of standard definitions for associated complications and premature removal reasons was identified. This scoping review demonstrates the need to standardise CVAD nomenclature to enhance communication between healthcare professionals as patients undergoing cancer treatment transition between acute and long-term care, to enhance patient safety and rigor of research protocols, and improve the capacity for data sharing.
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Affiliation(s)
- Kerrie Curtis
- Department of Nursing, University of Melbourne, Melbourne, Australia.
- Peter MacCallum Cancer Centre, Melbourne, Australia.
- Austin Health, Melbourne, Australia.
| | - Karla Gough
- Department of Nursing, University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Meinir Krishnasamy
- Department of Nursing, University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre Alliance, Melbourne, Australia
| | | | - Geoff Hill
- Royal Melbourne Hospital, Melbourne, Australia
| | - Samantha Keogh
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
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Giustivi D, Donadoni M, Elli SM, Casella F, Quici M, Cogliati C, Cavalli S, Rizzi G, La Cava L, Bartoli A, Martini E, Taino A, Perego M, Foschi A, Castelli R, Calloni M, Gidaro A. Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis. NURSING REPORTS 2024; 14:455-467. [PMID: 38391080 PMCID: PMC10885060 DOI: 10.3390/nursrep14010035] [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: 09/25/2023] [Revised: 12/31/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. METHODS Randomized controlled trials without language restrictions were searched using PUBMED®, EMBASE®, EBSCO®, CINAHL®, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. RESULTS There were no significant differences in overall success and nerve or artery injuries between the two groups (p = 0.62 and p = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (p < 0.001; RR0.41 [0.31-0.54] CI 95%), catheter-related thrombosis (p < 0.001; RR0.35 [0.20-0.59] IC 95%), infection-triggering catheter removal (p < 0.001; RR0.33 [0.18-0.61] IC 95%), wound oozing (p < 0.001; RR0.49 [0.37-0.64] IC 95%), and dislodgement (p < 0.001; RR0.4 [0.31-0.54] CI 95%). CONCLUSIONS The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization.
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Affiliation(s)
| | - Mattia Donadoni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Stefano Maria Elli
- Healthcare Profession Department-PICC Team, University of Milan Bicocca, IRCCS San Gerardo dei Tintori Foundation Hospital, 20126 Monza, Italy
| | - Francesco Casella
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Massimiliano Quici
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Chiara Cogliati
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Silvia Cavalli
- Healthcare Profession Department-PICC Team, University of Milan Bicocca, IRCCS San Gerardo dei Tintori Foundation Hospital, 20126 Monza, Italy
| | - Giulia Rizzi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Leyla La Cava
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Arianna Bartoli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Elena Martini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Alba Taino
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Martina Perego
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Antonella Foschi
- Department of Infectious Diseases, Luigi Sacco Hospital, 20157 Milan, Italy
| | - Roberto Castelli
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro N° 8, 07100 Sassari, Italy
| | - Maria Calloni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
| | - Antonio Gidaro
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20122 Milan, Italy
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Sheng Y, Yang LH, Wu Y, Gao W, Dongye SY. Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study. Clin Nurs Res 2024; 33:19-26. [PMID: 37596863 DOI: 10.1177/10547738231194099] [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] [Indexed: 08/20/2023]
Abstract
This study sought to evaluate the impact of the subcutaneous tunneling technique on peripherally inserted central catheter (PICC) placement. We randomized 694 patients who needed PICC placement to either the tunneled PICCs (experimental group) or the non-tunneled PICCs (control group) from August to December 2021. The cumulative frequency of complications was assessed as the primary outcome. Secondary outcomes comprised of the amount of bleeding, catheter insertion time, self-reported pain score, and one-puncture success rate. After 6 months of follow-up, the tunneled PICCs group showed a significant decrease in the frequency of total complications, especially in infection (3.0% vs. 7.1%, p = .021) and catheter-related thrombosis (3.3% vs. 8.3%, p = .008), although approximately 0.5 ml bleeding and 3.5 min time were increased. This randomized multicenter study supports the efficacy of subcutaneous tunneling technology in reducing PICC-related complications, enhancing patient comfort, and encouraging using subcutaneous tunneling technology for PICC placement.
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Affiliation(s)
- Yuan Sheng
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
- Medical School, Liaocheng University, China
| | - Li-Hong Yang
- Department of Hematology, Liaocheng People's Hospital, China
| | - Yan Wu
- Medical Oncology Center, Shandong University of Qilu Hospital, Jinan, China
| | - Wei Gao
- Department of PICCs Clinic, Shandong University of Qilu Hospital, Jinan, China
| | - Sheng-Yi Dongye
- Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
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Effect of Clinical Nursing Pathway Intervention Based on Evidence-Based Medicine on Venous Thrombosis in Long-Term Bedridden Patients. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5120569. [PMID: 35320999 PMCID: PMC8938046 DOI: 10.1155/2022/5120569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
Background Venous thrombosis is a type of medical condition that establishes as deep vein thrombosis of the limb or pulmonary embolism. This disease arises as a result of interrelating hereditary, ecological, and interactive risk aspects. Clinical nursing pathways also known as critical pathways are pathways that guide nurses when developing a patient's care plan. However, the effect of nursing intervention on venous thrombosis in long-term bedridden patients from the perspective of evidence-based medicine had not been reported. Methods A total of 170 patients hospitalized in the hospital from January 2021 to October 2021 were selected, and the bed time was more than 2 weeks. The patients were randomly divided into the control group and observation group. 85 cases in the control group received routine nursing in cardiology, and 85 cases in the observation group received clinical nursing pathway. Venous thrombosis, lower limb pain, swelling, D-dimer level, hemodynamic parameters, and nursing satisfaction were compared in two groups. Results The incidence of deep venous thrombosis in the observation group was 8.2%, lower than 24.7% in the control group (P < 0.05). The incidence of lower limb pain and elevated D-dimer in the observation group was lower than that in the control group (P < 0.05). The improvement of hemodynamic parameters such as SBP, DBP, CBV, PR, CI, and CO in the study group was better than that in the control group (P < 0.05). The satisfaction of the observation group was 90.58%, which was higher than that of the control group (82.35%) (P < 0.05). Conclusion Clinical nursing pathway can improve patients' nursing efficiency, improve the treatment effect, shorten hospital stay, and improve nursing satisfaction.
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Lu H, Yang Q, Yang L, Qu K, Tian B, Xiao Q, Xin X, Lv Y, Zheng X. The risk of venous thromboembolism associated with midline catheters compared with peripherally inserted central catheters: A systematic review and meta-analysis. Nurs Open 2021; 9:1873-1882. [PMID: 33991462 PMCID: PMC8994959 DOI: 10.1002/nop2.935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/15/2021] [Accepted: 03/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Both midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause venous thromboembolism (VTE), but the prevalence associated with each is controversial. Objective To compare the risk of VTE between MCs and PICCs with a systematic review and meta‐analysis. Methods The Web of Science Core Collection, PubMed, Scopus, Embase, the Cochrane Library and ProQuest were searched from inception to January 2020. All studies comparing the risk of VTE between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. Any different opinion was resolved through third‐party consensus. Meta‐analyses were conducted to generate estimates of VTE risk in patients with MCs versus PICCs, and publication bias was evaluated with RevMan 5.3. Results A total of 86 studies were identified. Twelve studies were recruited, involving 40,871 patients. The prevalence of VTE with MCs and PICCs was 3.97% (310/7806) and 2.29% (758/33065), respectively. Meta‐analysis showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.53, 95% CI: 1.33–1.76, p < .00001). Subgroup analyses by age showed that the prevalence of VTE with MCs was higher than that with PICCs in the adult group (RR=1.75, 95% CI: 1.38–2.22, p < .00001), and higher than that with PICCs in the other subgroups (RR=1.42, 95% CI: 1.19–1.69, p = .0001). Subgroup analyses by nation showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.50, 95% CI: 1.30–1.73, p < .00001) in US subgroup and higher than that with PICCs (RR=2.87, 95% CI: 1.24–6.65, p = .01) in the other nations. The sensitivity analysis shows that the results from this meta‐analysis are robust and all studies have no significant publication bias. Conclusions This study provides the first systematic assessment of the risk of VTE between MCs and PICCs. MCs are associated with a higher risk of VTE than PICCs in all patients and adults. The findings of this study have several important implications for future practice. However, the risk of VTE between MCs and PICCs in children is unclear.
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Affiliation(s)
- Huapeng Lu
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Qinling Yang
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lili Yang
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Kai Qu
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Boyan Tian
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qigui Xiao
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xia Xin
- Department of Nursing, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yi Lv
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Xuemei Zheng
- Department of Nursing, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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Xiao MF, Xiao CQ, Li J, Dai C, Fan YY, Cao HJ, Qin HY. Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial. J Int Med Res 2021; 49:3000605211004517. [PMID: 33840246 PMCID: PMC8044577 DOI: 10.1177/03000605211004517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs). METHODS One hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups. RESULTS In total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99-32.83) vs. 15.69 (10.51-57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups. CONCLUSIONS The subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.
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Affiliation(s)
- Mao-Fang Xiao
- School of Nursing, Sun Yat-sen University, Yuexiu District, Guangzhou, Guangdong, China
| | - Cai-Qiong Xiao
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Jia Li
- Department of Catheter Clinic, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Can Dai
- Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yu-Ying Fan
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Hui-Jiao Cao
- General Department, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Hui-Ying Qin
- Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
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Li J, Huang XF, Luo JL, Zhang JY, Liang XL, Huang CL, Qin HY. Effect of video-assisted education on informed consent and patient education for peripherally inserted central catheters: a randomized controlled trial. J Int Med Res 2020; 48:300060520947915. [PMID: 32910712 PMCID: PMC7488911 DOI: 10.1177/0300060520947915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate the effects of a video-assisted education intervention on informed consent and patient education for peripherally inserted central catheters (PICCs). METHODS We conducted a randomized controlled trial comparing the effects on informed consent of video-assisted patient education and traditional face-to-face discussion in a catheter outpatient ward of a cancer centre in Guangzhou, China, in 2018. Participants were 140 patients randomly allocated (1:1 ratio) to two groups: video-assisted or traditional intervention. General information, patient retention of PICC-related information, working time spent by nurses on the procedure, and patient and nurse satisfaction with the procedure were assessed. RESULTS The time used for informed consent was significantly shorter in the experimental group (1.02 ± 0.24 minutes) than in the control group (6.87 ± 1.10 minutes). The time used for PICC-related education was significantly shorter in the experimental group (1.03 ± 0.28 minutes) than in the control group (5.11 ± 0.57 minutes). Nurses' degree of satisfaction with the procedure was significantly higher in the experimental group (4.10 ± 0.57) than in the control group (2.60 ± 0.70). CONCLUSION The use of video-assisted informed consent and patient education in this cancer centre decreased nurses' working time and improved nurses' satisfaction.Clinical trial registration number: ChiCTR1800015664.
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Affiliation(s)
- Jia Li
- Department of Catheter Outpatient Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Xue-Fang Huang
- Department of Outpatient Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Jie-Lin Luo
- Department of Catheter Outpatient Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Jiang-Yun Zhang
- Department of Outpatient Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Xiao-Lin Liang
- Department of Outpatient Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Chun-Li Huang
- Department of Outpatient Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Hui-Ying Qin
- Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
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