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Beleza LDO, Brasil GDC, Margatho AS, Vasques CI, Silveira RCDCP, Rocha PRS, Ribeiro LM. Prevention of complications related to peripherally inserted central catheter insertion techniques in newborns: systematic review and network meta-analysis. Rev Lat Am Enfermagem 2024; 32:e4161. [PMID: 38985042 PMCID: PMC11251685 DOI: 10.1590/1518-8345.6905.4161] [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: 06/26/2023] [Accepted: 01/06/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE to analyze the effectiveness of peripherally inserted central catheter insertion techniques in preventing the occurrence of complications related to this device in newborns. METHOD a paired and network systematic literature review and meta-analysis, with its search carried out in seven databases and in the Grey Literature, including randomized and non-randomized clinical trials. The risk of bias was assessed using the Cochrane Risk of Bias 2 and Risk of Bias In Non-randomized Studies of Interventions tools. Certainty of the evidence was assessed by means of the Grading of Recommendations Assessment, Development and Evaluation. A meta-analysis was carried out with the aid of the R statistical program. RESULTS eight studies with 1,126 newborns were included and six insertion techniques were identified: intracavitary electrocardiogram; intracavitary electrocardiogram associated with ultrasound; ultrasound; formula; anatomical landmark; and modified anatomical landmark. Five techniques significantly decreased primary tip malpositioning when compared to the control ( p <0.05). Intracavitary electrocardiogram significantly and more effectively reduced arrhythmias, general complications and phlebitis; the technique that used a formula also reduced general complications. Infection, infiltration, secondary tip malpositioning, catheter rupture, thrombosis, occlusion and catheter-associated skin lesion were not significantly preventable events. CONCLUSION intracavitary electrocardiogram and use of the formula were the most effective techniques in reducing complications.
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Affiliation(s)
- Ludmylla de Oliveira Beleza
- Universidade de Brasília, Brasília, DF, Brazil
- Secretaria do Estado de Saúde, Hospital Materno Infantil de Brasília, UTI Neonatal, Brasília, DF, Brazil
| | | | - Amanda Salles Margatho
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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da Silva PAL, Lima AFC. Direct costs of treating men with prostate cancer with High Intensity Focused Ultrasound. Rev Esc Enferm USP 2023; 57:e20230132. [PMID: 38009909 PMCID: PMC10680442 DOI: 10.1590/1980-220x-reeusp-2023-0132en] [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: 04/26/2023] [Accepted: 09/26/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE To analyze the direct costs of materials, medicines/solutions and healthcare professionals required to treat men with prostate cancer using High Intensity Focused Ultrasound. METHOD Quantitative, exploratory-descriptive research, single case study type. Data were collected from electronic medical records/printed documentation from the Operating Room of a public teaching and research hospital. Health professionals estimated the respective time spent on activities in the following stages: "Before anesthetic induction", "Before performing thermal ablation", "During thermal ablation" and "After performing thermal ablation". Costs were calculated by multiplying the (estimated) time spent by the unit cost of direct labor, adding to the measured cost of materials, medicines/solutions. RESULTS The measured costs with materials corresponded to US$851.58 (SD = 2.17), with medicines/solutions to US$72.13 (SD = 25.84), and estimated personnel costs to US$196.03, totaling US$1119.74/procedure. CONCLUSION The economic results obtained may support hospital managers in the decision-making process regarding the adoption of the High Intensity Focused Ultrasound for the treatment of prostate cancer.
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Affiliation(s)
- Pâmela Adalgisa Lopes da Silva
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Gerenciamento em Enfermagem, São Paulo, SP, Brazil
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Pereira HP, Secco IL, Arrué AM, Pontes L, Danski MTR. Implementation of modified Seldinger technology for percutaneous catheterization in critically ill newborns. Rev Esc Enferm USP 2023; 57:e20220347. [PMID: 37402230 PMCID: PMC10328393 DOI: 10.1590/1980-220x-reeusp-2022-0347en] [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: 12/09/2022] [Accepted: 04/05/2023] [Indexed: 07/06/2023] Open
Abstract
OBJECTIVE To describe the implementation of Modified Seldinger Technology for percutaneous catheterization in critically ill newborns. METHOD A quasi-experimental before- and-after study, carried out with neonatologist nurses in a Neonatal Intensive Care Unit. RESULTS Seven nurses participated in the research. Catheter pre-insertion, insertion and maintenance were assessed using the conventional and modified Seldinger technique. Reliability was satisfactory in pre-test, 5.40 (Md = 6.00), and post-test, 5.94 (Md = 7.00), and perfect in the items about device insertion and maintenance. There was low assertiveness in the items on indication, microintroduction procedure via ultrasound, limb repositioning and disinfection of connections/connectors. CONCLUSION Despite the Modified Seldinger Technique expanding some stages of execution over the traditional method of percutaneous catheterization, nurses were more assertive after theoretical-practical training. The technology was implemented and is in the process of being implemented in the health service.
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Affiliation(s)
- Higor Pacheco Pereira
- Universidade Federal do Paraná, Hospital Infantil Waldemar Monastier, Campo Largo, PR, Brazil
| | - Izabela Linha Secco
- Universidade Federal do Paraná, Hospital Infantil Waldemar Monastier, Campo Largo, PR, Brazil
| | | | - Letícia Pontes
- Universidade Federal do Paraná, Departamento de Enfermagem, Curitiba, PR, Brazil
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Alves VLDS, Lima AFC. In loco nursing practice inspection costs in a Brazilian setting. Rev Esc Enferm USP 2022; 56:e20210382. [PMID: 35099497 PMCID: PMC10132837 DOI: 10.1590/1980-220x-reeusp-2021-0382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To identify the average direct cost related to the direct labor of the inspectors involved in the “in loco inspection” step of the inspection process carried out at the Headquarters of the Regional Nursing Council of São Paulo. Method: Quantitative, exploratory-descriptive research, in the form of a single case study. The non-probabilistic convenience sample consisted of records of initial and return “in loco inspections”, carried out by inspectors working at the Headquarters of The Regional Nursing Council of São Paulo, from January 13, 2020 to March 13, 2020. Results: The average direct cost of initial in loco inspection (N = 182) corresponded to BRL 331.67 (SD = 140.32), ranging from BRL 115.80 to BRL 1071.15, and that of return in loco inspection (N = 98) to BRL 256.16 (SD = 130.90), ranging from BRL 77.20 to BRL 694.80. Time and cost variables analysis of initial and return in loco inspections showed an alpha significance level of 0.05, and it was possible to statistically state that the time (p ≤ 0.001) and the cost of initial in loco inspection (p ≤ 0.001) are higher than those for return in loco inspection. Conclusion: the cost of the step of “in loco inspection” will support the Nursing Council in the decision-making process aiming at allocating efficiency of human resources required in the inspection process.
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Tomazoni A, Rocha PK, Pedreira MDLG, Rodrigues EDC, Manzo BF, Santos LMD. Methods for measuring venous peripherally inserted central catheters in newborns. Rev Bras Enferm 2021; 75:e20210045. [PMID: 34669907 DOI: 10.1590/0034-7167-2021-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/08/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze the results of insertion procedures of Peripherally Inserted Central Catheters in newborns using two measurement methods. METHODS this is a randomized clinical trial, presenting descriptive and exploratory results of variables. It was held at a Neonatal Intensive Care Unit. Data were collected between September 2018 and 2019. The sample analyzed was 88 catheter insertion procedures, distributed in two groups. Study approved by an Institutional Review Board and obtained registration in the country and abroad. Descriptive analysis and logistic regression of data. RESULTS modified measurement obtained a significant difference for the central catheter tip location. Elective removals and adverse events were not significant between groups; however, poor positioning was related to adverse events. CONCLUSIONS between the two methods analyzed, the modified measurement obtained better results in the proper catheter tip positioning and, consequently, less risk to patients.
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Affiliation(s)
- Andreia Tomazoni
- Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brazil
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de Melo ACT, Lima AFC. Direct costs of rescue procedures to manage vascular access complications in conventional hemodialysis. Rev Esc Enferm USP 2021; 55:e20210156. [PMID: 34516605 DOI: 10.1590/1980-220x-reeusp-2021-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/29/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To measure the average direct cost of procedures performed by health professionals, in a Dialysis Center, for the management of complications of vascular access for hemodialysis. METHOD Quantitative, exploratory-descriptive case study type research. The average direct cost was calculated by multiplying the time spent by health professionals by the unit cost of direct labor, adding this to the input costs (materials/ medicines/solutions). RESULTS The following average direct costs were obtained: US$0.72, US$2.00 and US$1.41 for "administration of easy-to-dilute, difficult-to-dilute, and undiluted antibiotics", respectively; $2.61 for "central venous catheter dressing with topical antibiotic"; $48.05 for "alteplase infusion"; US$183.68 for "insertion of central venous catheter for hemodialysis"; and $1.31 for "arteriovenous fistula puncture". CONCLUSION Material and drug costs significantly contributed to the composition of the average total direct cost of most procedures.
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Assis GLCD, Mota ANB, Cesar VF, Turrini RNT, Ferreira LM. Direct cost of Peripherally Inserted Central Venous Catheter insertion by nurses in hospitalized adults. Rev Bras Enferm 2021; 74:e20190663. [PMID: 34161537 DOI: 10.1590/0034-7167-2019-0663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/21/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the average direct cost of PICC insertion by nurses. METHODS this is a unique case study with a quantitative approach. The observation took place in a public hospital, collecting information on inputs used and procedure length. For the calculation of costs, time was multiplied by nurses' costs plus supplies. The US dollar was used to present the calculations. In the analysis, descriptive statistics of measures of central tendency and variability were used. RESULTS the sample corresponded to 139 observations. The average cost of PICC insertion totaled US$286.04, with 90.8% of materials, mainly catheter, and 9.2% of the labor. The procedure took an average of 50 minutes, at US$0.26 per minute for nurses. Conclusions: the average direct cost of PICC insertion was US$286.04, with emphasis on the catheter. The results can support management decisions for adequate material and professional sizing.
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