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Pérez-Granda MJ, Irigoyen-von-Sierakowski Á, Toledo N, Rodríguez E, Cruz ML, Hernanz G, Serra JA, Kestler M, Muñoz P, Guembe M. Impact of an interventional bundle on complications associated with peripheral venous catheters in elderly patients. Eur J Clin Microbiol Infect Dis 2024; 43:703-712. [PMID: 38326546 DOI: 10.1007/s10096-024-04771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Elderly patients admitted to geriatrics departments often require peripheral venous catheters (PVC), which should be inserted and maintained following a series of preventive recommendations. Our objective was to evaluate the impact of a training bundle comprising measures aimed at reducing complications associated with the use of PVC in elderly patients admitted to a tertiary teaching hospital. METHODS We performed a prospective study of patients who received a PVC within 24 h of admission to a geriatrics department. After a 10-month pre-interventional period, we implemented an educational and interventional bundle over a 9-month period. Follow-up was until catheter withdrawal. We analyzed and compared clinical and microbiological data between both study periods. RESULTS A total of 344 patients (475 PVC) were included (pre-intervention period, 204 patients (285 PVC); post-intervention period, 140 patients (190 PVC)). No statistically significant differences in demographic characteristics were observed between the study periods. The colonization and phlebitis rates per 1000 admissions in both periods were, respectively, 36.7 vs. 24.3 (p = 0.198) and 81.5 vs. 65.1 (p = 0.457). The main reason for catheter withdrawal was obstruction/malfunctioning (33.3%). Obstruction rate was higher for those inserted in the hand than for those inserted at other sites (55.7% vs. 44.3%, p = 0.045). CONCLUSIONS We found no statistically significant differences regarding phlebitis and catheter tip colonization rates. It is necessary to carry out randomized studies assessing the most cost-effective measure to reduce complications associated with PVC.
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Affiliation(s)
- María Jesús Pérez-Granda
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | - Álvaro Irigoyen-von-Sierakowski
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain
| | - Neera Toledo
- Intermal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Eva Rodríguez
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Luisa Cruz
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Giovanna Hernanz
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Antonio Serra
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Biomedical Research Networking Centre On Frailty and Healthy Ageing, CIBERFES, Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Martha Kestler
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain
| | - Patricia Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain.
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
- Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - María Guembe
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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Banakh I, Turek M, Niewodowski D, Sriamareswaran RK, Yeaman F, Vo L, Churchill T. Ultrarapid Iron Polymaltose Infusions Are Safe for Management of Iron Deficiency. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2024; 31:24-32. [PMID: 38476307 PMCID: PMC10928866 DOI: 10.1159/000527794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 10/14/2022] [Indexed: 03/14/2024]
Abstract
Introduction Iron deficiency is a common condition, especially among patients with kidney and heart failure and inflammatory bowel disease. Intravenous iron is the preferred method of treatment in these patients, but it usually requires prolonged iron polymaltose infusions or multiple administrations of alternative preparations. The aim of the study was to confirm the safety and patient acceptance of ultrarapid iron polymaltose infusions as an alternative to slower treatments and ferric carboxymaltose. Method An open-label, phase 4 safety study was conducted at a tertiary hospital, with consenting participants diagnosed with iron deficiency and requiring iron polymaltose up to 1,500 mg receiving the infusion over 15 min. The acute adverse event (AE) rates and their severities were compared to historical controls of 1- and 4-h iron polymaltose infusions from a retrospective study of 648 patients from the same study site. Delayed AEs as well as participant infusion acceptability were also studied. Results Three hundred participants over a 2-year period received ultrarapid infusions of iron polymaltose with an acute AE rate of 18.7% and severe AE rate of 1.0%. The total and mild infusion AE rates were higher compared to those of slower infusions (p < 0.001), but comparable for moderate and severe AEs. Delayed reactions occurred in 12.5% of participants, with over 95% of them preferring repeat ultrarapid infusions if required again. Conclusion Iron polymaltose can be safely infused at ultrarapid rates when compared to slower infusions, with similar safety to ferric carboxymaltose, offering greater convenience for patients and reduced healthcare costs.
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Affiliation(s)
- Iouri Banakh
- Emergency Department Pharmacy Team leader, Pharmacy Department, Monash Medical Centre, Monash Health, Melbourne, Victoria, Australia
| | - Martha Turek
- Senior Pharmacist, Mental Health, Pharmacy Department, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia
| | - Daniel Niewodowski
- General Medicine Hospital Medical Officer, Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia
| | - Rumes Kanna Sriamareswaran
- Cardiology Registrar, Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia
| | - Fiona Yeaman
- Gastroenterology Advanced Trainee, Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia
| | - Lilian Vo
- Clinical Pharmacist, Pharmacy Department, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia
| | - Travis Churchill
- General Medicine Registrar, Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, Victoria, Australia
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Aksoy F, Bayram SB. The effect of warm moist compresses in peripheral intravenous catheter-related phlebitis. Eur J Oncol Nurs 2023; 67:102438. [PMID: 37913684 DOI: 10.1016/j.ejon.2023.102438] [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: 07/31/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE Phlebitis is a common complication in palliative patients. There are limited nursing practices in phlebitis care. The study was conducted to determine the effect of warm moist compresses in patients with peripheral intravenous catheter-related phlebitis. METHODS 70 patients (35 control and 35 experimental) with phlebitis symptoms who were hospitalized in the palliative clinic of a training and research hospital were recruited for the study. The phlebitis site of the patients in the control and experimental groups were followed for three days. While the control group received routine nursing care, the experimental group received a warm moist compresses at 28 °C for 15 min three times a day for three days in addition to routine nursing care. RESULTS According to the results, there was a decrease in the initial and final phlebitis grades between the control and experimental groups, but the difference was not statistically significant (p = 0.957, p = 0.078). In the final evaluation of the phlebitis site, a statistically significant difference was observed in redness, edema width, and pain intensity between the control and experimental groups in favor of the experimental group (p˂0.001, p = 0.006, p˂0.001, respectively). CONCLUSIONS It was determined that applying warm water compresses three times a day in phlebitis care had a positive effect on healing.
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Affiliation(s)
- Fatma Aksoy
- Karadeniz Technical University, Institute of Health Sciences, Trabzon, Turkey.
| | - Sule Biyik Bayram
- Karadeniz Technical University, Faculty of Health Sciences, Department of Nursing, Trabzon, Turkey.
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de Souza LC, Campos JF, de Oliveira HC, de Azevedo Vianna C, de Bakker GB, Machado DM, Brandão MAG, da Silva RC. Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study. Nurse Educ Pract 2023; 71:103734. [PMID: 37544240 DOI: 10.1016/j.nepr.2023.103734] [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: 10/11/2022] [Revised: 03/06/2023] [Accepted: 07/22/2023] [Indexed: 08/08/2023]
Abstract
AIM to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses. BACKGROUND The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure. DESIGN A randomized simulation experimental pre-post interventional study. METHODS Sixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures. RESULTS Performance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively. CONCLUSIONS The rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses' performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.
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Affiliation(s)
- Lucimar Casimiro de Souza
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil.; Hospital Samaritano Botafogo, Rua Assunção, 275, Botafogo, Zipcode: 22251-030 Rio de Janeiro, Brazil
| | - Juliana Faria Campos
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil..
| | - Hudson Carmo de Oliveira
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil
| | - Carla de Azevedo Vianna
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil.; Pró-Cardíaco Hospital, Rua General Polidoro 192, Botafogo, Zipcode: 22280-003, Rio de Janeiro, Brazil
| | - Gabriela Barcellos de Bakker
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil.; Americas Medical City Hospital, Rua Jorge Cury 550, Barra da Tijuca, Zipcode: 22775-00, Rio de Janeiro, Brazil
| | - Debora Mazioli Machado
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil.; Pró-Cardíaco Hospital, Rua General Polidoro 192, Botafogo, Zipcode: 22280-003, Rio de Janeiro, Brazil
| | - Marcos Antônio Gomes Brandão
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil
| | - Rafael Celestino da Silva
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rua Afonso Cavalcanti, 275/ Cidade Nova, Zipcode: 20211-110, Rio de Janeiro, Brazil
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Giri J, Poojary A, Coto BS, Agarwal A, Datta B, Ganguly S, Hindlekar P, Patil P, Vitto JVA, Choi A, Kim S, Basaiawmoit B, Biswas D, Prabhakar S, Sharma A, Deshwal N, Shin JA, Jung J, Eshwara VK, Varma M, Mukhopadhyay C, Mundkur SC, Shetty A, Kurup S, Rajalakshmi A, Kumar R, Shah S, Fouzdar H, Park O, Kim H, Budhiraja S, Verma A, Dutt A, Mehta Y, Patil N, Pollatu JC, Rikumahu M, Inchaiya P, Weangsima D, McCaughan J, Chandra R, Setyohariyati FDS, Sihite CRJ, Bawaningtyas BB, Octaviani SN, Hoai VTT, Sang DM, Van Thang B, Van Anh DT. Preventing Risks of Infections and Medication Errors in IV therapy (PRIME): a patient safety initiative. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S4-S12. [PMID: 37495417 DOI: 10.12968/bjon.2023.32.14.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Two major avoidable reasons for adverse events in hospital are medication errors and intravenous therapy-induced infections or complications. Training for clinical staff and compliance to patient safety principles could address these. METHODS Joint Commission International (JCI) consultants created a standardised, 6-month training programme for clinical staff in hospitals. Twenty-one tertiary care hospitals from across south-east Asia took part. JCI trained the clinical consultants, who trained hospital safety champions, who trained nursing staff. Compliance and knowledge were assessed, and monthly audits were conducted. RESULTS There was an overall increase of 29% in compliance with parameters around medication preparation and vascular access device management. CONCLUSION The programme improved safe practice around preparing medications management and managing vascular access devices. The approach could be employed as a continuous quality improvement initiative for the prevention of medication errors and infusion-associated complications.
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Affiliation(s)
- Jayant Giri
- Director - Medical Affairs, Greater Asia, Becton, Dickinson and Company, Singapore
| | - Aruna Poojary
- Head of Department, Department of Pathology and Microbiology, and Head, Infection Prevention and Control, Breach Candy Hospital Trust, Mumbai, India
| | - Berling S Coto
- Director of Nursing, Chinese General Hospital and Medical Centre, Philippines
| | - Anuradha Agarwal
- Head, Quality and Infection Control, Belle Vue Clinic, Kolkata, India
| | - Babli Datta
- Executive, Infection Control, Belle Vue Clinic, Kolkata, India
| | - Sumana Ganguly
- Medical officer in charge, Belle Vue Clinic, Kolkata, India
| | - Prajakta Hindlekar
- Director Nursing and Chief Experience Officer, Breach Candy Hospital Trust, Mumbai, India
| | - Priyanka Patil
- Infection Control Officer, Breach Candy Hospital Trust, Mumbai, India
| | - Jasmine Virginia A Vitto
- Nurse, Nursing Service Education Committee, Chinese General Hospital and Medical Centre, Philippines
| | - Aeri Choi
- Ewha Woman's University Mokdong Hospital, Seoul, Republic of Korea
| | - Sookhyun Kim
- Nursing team manager, Ewha Woman's University Mokdong Hospital, Seoul, Republic of Korea
| | | | - Doli Biswas
- Chief of Nursing, Fortis Hospital, Anandapur, Kolkata, India
| | - Shweta Prabhakar
- Regional Quality Head-North and East, Fortis Hospital, Mohali, India
| | - Anita Sharma
- Consultant in Microbiology and Head of Infection Control, Fortis Hospital, Mohali, India
| | | | - Jeong Ae Shin
- Leader, Quality Improvement, Inha University Hospital, Incheon, Republic of Korea
| | - JinYoung Jung
- Nurse, Quality Improvement, Inha University Hospital, Incheon, Republic of Korea
| | - Vandana Kalwaje Eshwara
- Professor and Head, Department of Microbiology, Kasturba Medical College and Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Muralidhar Varma
- Associate Professor, Department of Infectious Diseases, Kasturba Medical College and Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Chiranjay Mukhopadhyay
- Associate Dean and Professor of Microbiology, Kasturba Medical College and Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Suneel C Mundkur
- Professor, Department of Pediatrics, Kasturba Medical College and Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Avinash Shetty
- Medical Superintendent and Professor of Community Medicine, Department of Community Medicine, Kasturba Medical College and Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shreeshubha Kurup
- Deputy General Manager, Quality Department, KIMSHEALTH, Trivandrum, India
| | | | - Rajiv Kumar
- Head of Quality, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai, India
| | - Sweta Shah
- Lead Consultant, Microbiology and Infection Prevention, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai, India
| | - Havovi Fouzdar
- General Manager, Nursing, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai, India
| | - OkSim Park
- Chief Nursing Director, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - HeeJung Kim
- Leader, Quality and Patient Safety, Nursing Department, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Sandeep Budhiraja
- Director, Clinical Services, Max Superspecialty Hospital, Saket, New Delhi, India
| | - Arati Verma
- Vice President-Quality, Max Superspecialty Hospital, Saket, New Delhi, India
| | - Arti Dutt
- Chief Nursing Officer, Max Superspecialty Hospital, Saket, New Delhi, India
| | - Yatin Mehta
- Chairman, Critical Care and Anesthesia, Medanta-the Medicity, Gurgaon, India
| | - Nipun Patil
- Head, Dept of Clinical Pharmacy and Pharmacology, Medanta-the Medicity, Gurgaon, India
| | | | - Marisco Rikumahu
- Clinical Nurse Educator Coordinator, MRCCC Hospital, Jakarta, Indonesia
| | - Phatharaporn Inchaiya
- Section Nurse Manager-Coronary Crisis Patient Group, Sikarin Hospital, Bangkok, Thailand
| | - Dararut Weangsima
- Section Nurse Manager-Coronary Crisis Patient Group, Bangkok, Thailand
| | - Julie McCaughan
- Chief Quality and Nursing Officer Siloam Hospitals Head Office, Lippo Village, Tangerang, Banten, Indonesia
| | - Riny Chandra
- Division Head, Nursing Professional Development, Siloam Hospitals Head Office, Lippo Village, Tangerang, Banten, Indonesia
| | | | - Christin Rouli Juni Sihite
- Clinical Nurse Instructor-Intensive Area Pain Nurse Coordinator, Siloam Lippo Village Hospital, Tangerang, Banten, Indonesia
| | | | - Susi Nur Octaviani
- Wound Nurse Coordinator, Siloam Sriwijaya Palembang, Sumatera Selatan, Indonesia
| | - Vu Thi Thu Hoai
- Head Nurse, Intensive Care Unit, Vinmec Central Park International Hospital, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - Doan Minh Sang
- Vinmec Central Park International Hospital, 208 Nguyen Huu Canh Street, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - Bui Van Thang
- Chief Nursing Officer, Nursing Department, VinMec Times City Internation Hospital, 458 Minh Khai, Vinh Tuy Ward, Hai Ba Trung District, Hanoi, Vietnam
| | - Dinh Thi Van Anh
- Senior nurse, Nursing Department, VinMec Times City Internation Hospital, 458 Minh Khai, Vinh Tuy Ward, Hai Ba Trung District, Hanoi, Vietnam
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Wang Q, Luo F, Fan X, Cheng X, Ma X, Shi L, Zhang P. Application of epicutaneo-cava catheters with 24G indwelling needles in very low birth weight infants: a safe and simple innovative technique. Front Pediatr 2023; 11:1172164. [PMID: 37303751 PMCID: PMC10248414 DOI: 10.3389/fped.2023.1172164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
Background Epicutaneo-cava catheter (ECC) is an ideal venous access for very low birth weight (VLBW) infants. However, because veins of VLBW infants are thin, ECC catheter is difficult to insert, and the success rate of puncture is low. This study aimed to use ECC with 24G indwelling needles to improve the outcomes of VLBW infants. Methods This retrospective study enrolled 121 VLBW infants (birthweight <1,500 g) who required ECC catheterization and were admitted to the Neonatal Intensive Care Unit of the Children's Hospital of Zhejiang University School of Medicine between January 2021 and December 2021. The patients were divided into the indwelling needle group and the conventional technique group according to the technique of ECC. The demographic and treatment data of the two groups were collected, and the success rate of first attempt cannulation of ECC and catheter-related complications of the two groups were analyzed and compared. Results There were no significant differences in gender, age, and body weight between the two groups on the day of ECC insertion and venipuncture site. It can be seen through model analysis that the success rate of first-attempt cannulation of ECC in the indwelling needle group was significantly higher than in the conventional technique group. In contrast, average catheterization time and catheterization-related bleeding risk in the indwelling needle group were significantly lower than in the conventional technique group (p = 0.00,and 0.00, respectively). Infection during catheter placement, indwelling catheter duration and catheter-related infection between the two groups (p > 0.05). Conclusion Application of ECC with 24G indwelling needles in VLBW infants can improve the success rate of first attempt cannulation of ECC, reduce the time of catheterization and the risk of bleeding, which may be popularized for widespread application.
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Affiliation(s)
- Qin Wang
- NICU, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feixiang Luo
- NICU, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Fan
- NICU, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoying Cheng
- Quality Management Office, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaolu Ma
- NICU, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Liping Shi
- NICU, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Pei Zhang
- NICU, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Liew YX, Lee HLW, Lim TP, Teo JQM, Chlebicki MP, Chung SJ, Kwa ALH. High-concentration polymyxin B infusion: is it safe to give? Int J Antimicrob Agents 2023; 61:106688. [PMID: 36402447 DOI: 10.1016/j.ijantimicag.2022.106688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/29/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Yi Xin Liew
- Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore, Singapore
| | - Hui-Ling Winnie Lee
- Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore, Singapore
| | - Tze-Peng Lim
- Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore, Singapore; Singhealth Duke-NUS Medicine Academic Clinical Programme, Singapore, Singapore; Singhealth Duke-NUS Pathology Academic Clinical Programme, Singapore, Singapore
| | - Jocelyn Qi-Min Teo
- Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore, Singapore
| | - Maciej Piotr Chlebicki
- Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Shimin Jasmine Chung
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | - Andrea Lay Hoon Kwa
- Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore, Singapore; Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore; Singhealth Duke-NUS Medicine Academic Clinical Programme, Singapore, Singapore.
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8
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Murayama R, Oyama H, Abe-Doi M, Masamoto Y, Kashiwabara K, Tobe H, Komiyama C, Sanada H, Kurokawa M. Safety verification of a new peripheral intravenous catheter placed in the upper arm vein for administration of drugs with high irritant potential. Drug Discov Ther 2022; 16:128-134. [PMID: 35753769 DOI: 10.5582/ddt.2022.01034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite the widespread use of peripheral intravenous catheters, unscheduled catheter failure before completion of treatment occurs frequently. If a large vein is selected, catheter failures may be prevented despite administering a highly irritant drug. In this study, we attempted to use a catheter that can be placed in a large upper arm vein. The new catheter was 88 mm long but had no guidewire to reduce contamination risk. This study aimed to evaluate the safety of the first-in-human trial for the new catheter with the administration of highly irritant drugs. This study was conducted at a university hospital in Tokyo, Japan. Eight Japanese adults were hospitalized adults with planned administration of non-cancer drugs with high irritant potential using a peripheral catheter. A trained nurse catheterized with the new catheter in the upper arm using ultrasonography. The catheterization site was monitored by staff and a research nurse once every 24 hours for up to 7 days. No adverse events or catheter failure occurred and the catheter placement success rate was 100%. In two patients, a temporary occlusion alarm of the infusion pump occurred, possibly due to the flexion of the catheter base. The new peripheral intravenous catheter did not interrupt medical treatments as is common after placement, but safety administered the irritant drugs. However, because this catheter may be easily affected by the contraction of the muscle at the fixation position, the position and method of catheter fixation in the upper arm need to be carefully considered.
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Affiliation(s)
- Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hajime Oyama
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mari Abe-Doi
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Masamoto
- Department of Hematology and Oncology, The University of Tokyo Hospital, Tokyo, Japan
| | - Kosuke Kashiwabara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiromi Tobe
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chieko Komiyama
- Nursing Department, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, The University of Tokyo Hospital, Tokyo, Japan
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Hernandez-Montfort J, Miranda D, Randhawa VK, Sleiman J, de Armas YS, Lewis A, Taimeh Z, Alvarez P, Cremer P, Perez-Villa B, Navas V, Hakemi E, Velez M, Hernandez-Mejia L, Sheffield C, Brozzi N, Cubeddu R, Navia J, Estep JD. Hemodynamic-based Assessment and Management of Cardiogenic Shock. US CARDIOLOGY REVIEW 2022. [DOI: 10.15420/usc.2021.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cardiogenic shock (CS) remains a deadly disease entity challenging patients, caregivers, and communities across the globe. CS can rapidly lead to the development of hypoperfusion and end-organ dysfunction, transforming a predictable hemodynamic event into a potential high-resource, intense, hemometabolic clinical catastrophe. Based on the scalable heterogeneity from a cellular level to healthcare systems in the hemodynamic-based management of patients experiencing CS, we present considerations towards systematic hemodynamic-based transitions in which distinct clinical entities share the common path of early identification and rapid transitions through an adaptive longitudinal situational awareness model of care that influences specific management considerations. Future studies are needed to best understand optimal management of drugs and devices along with engagement of health systems of care for patients with CS.
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Affiliation(s)
| | - Diana Miranda
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Varinder Kaur Randhawa
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Jose Sleiman
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Yelenis Seijo de Armas
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Antonio Lewis
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Ziad Taimeh
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Paulino Alvarez
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Paul Cremer
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Bernardo Perez-Villa
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Viviana Navas
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Emad Hakemi
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Mauricio Velez
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Luis Hernandez-Mejia
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Cedric Sheffield
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Nicolas Brozzi
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Robert Cubeddu
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Jose Navia
- Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston Hospital, Weston, FL
| | - Jerry D Estep
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
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Golsorkhi M, Azarfar A, Abdipour A. Vascular Access in Therapeutic Apheresis: One Size Does not Fit All. Ther Apher Dial 2022; 26:694-716. [PMID: 35043567 DOI: 10.1111/1744-9987.13799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/19/2021] [Accepted: 01/13/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Therapeutic apheresis has been used in treating hematological and non-hematological diseases. For a successful procedure, efficient vascular access is required. Presently, peripheral venous access (PVA), central venous catheterization (CVC), implantable ports, and arteriovenous fistulas (AVFs) are used. This review aims to evaluate different type of access and their pros and cons to help physicians determine the best venous access. METHODS The electronic search included PubMed and Google Scholar up to Nov. 2020. The Mesh terms were apheresis, peripheral catheterization, central catheterization, and arteriovenous fistula. RESULTS A total of 228 studies were found through database searching. Two independent authors reviewed the articles using their titles and abstracts; 88 articles were selected and the full text was reviewed. Finally, 25 were included. The inclusion criteria were studies incorporating patients with any indication for apheresis. CONCLUSION PVA has been promoted in recent years in many centers across the United States to lower the rate of complications associated with vascular access and to make this procedure more accessible. Several factors are involved in selecting appropriate venous access, such as the procedure's duration and frequency, patient's vascular anatomy, and staff's experience. In short-term procedures, temporary vascular access like PVA or CVC is preferred. Permanent vascular access such as AVF, tunneled cuffed central lines, and implantable ports are more beneficial in prolonged treatment period but each patient has to be evaluated individually by apheresis team for the most appropriate method.
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Affiliation(s)
- Mohadese Golsorkhi
- Department of Medicine, Division of Regenerative Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Anoush Azarfar
- Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Abdipour
- Department of Medicine, Division of Nephrology, Loma Linda University, Loma Linda, CA, USA
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11
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García-Expósito J, Reguant M, Canet-Vélez O, Ruiz Mata F, Botigué T, Roca J. Evidence of learning on the insertion and care of peripheral venous catheters in nursing students: A mixed study. NURSE EDUCATION TODAY 2021; 107:105157. [PMID: 34624618 DOI: 10.1016/j.nedt.2021.105157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/18/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES 1) To assess nursing students' evidence-based knowledge on the use of PVCs, and 2) to examine the perception of learning and teaching strategies aimed at this skill. BACKGROUND Insertion and care of Peripheral Venous Catheters (PVCs) are essential skills in undergraduate nursing education. Appropriate knowledge of this skill is crucial to improve clinical practice and patient safety. Therefore, training becomes an enabler for safe practice. DESIGN A multi-centre convergent parallel mixed-methods. SETTING AND PARTICIPANTS A total of 675 second-, third- and fourth-year nursing students from 3 nursing schools took part in the study. METHODS Quantitative data collection used a validated 15-question survey on knowledge of PVC management, and a descriptive and inferential analysis was carried out. Qualitative data were collected via a questionnaire consisting of 4 open-ended questions assessing knowledge, teaching methodologies and scenarios, and points for improvement. RESULTS Most participants were female (74.04%), with a mean age of 22.45 (SD = 4.65), who had no experience in the health field (61.8%). They obtained a mean knowledge score of 7.27 (SD = 2.64) out of 15. The students who obtained higher scores had a mean professional experience of 7.96, SD = 2.66 (p 0.000) and were in their final year, with a mean of 8.59, SD = 2.56, (p 0.000). On the other hand, the students assessed their knowledge as basic but improving year by year. They also identified a need to apply more active and experiential methodologies that would allow for reflection. CONCLUSION Level of educational level and experience is associated with increased knowledge. In order to improve knowledge, changes must be made in the training process to incorporate methodologies such as simulation and online training. There is a need to develop programmes that favour the alignment of theory with clinical practice.
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Affiliation(s)
- Judith García-Expósito
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, St., 25198 Lleida, Spain
| | - Mercedes Reguant
- Department of Research Methods and Diagnosis in Education, University of Barcelona, 171 Passeig de la Vall d'Hebron, St., 08035 Barcelona, Spain.
| | - Olga Canet-Vélez
- Faculty of Health Sciences Blanquerna, University Ramon Llull, Spain; Global Health, Gender and Society Research Group (GHenderS), 326-332 Padilla, St, 08025 Barcelona, Spain.
| | - Francisca Ruiz Mata
- School of Nursing Gimbernat, University Autònoma de Barcelona, Av. De la Generalitat, 202-206, 08174 Barcelona, Spain.
| | - Teresa Botigué
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, St., 25198 Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, 80 Alcalde Rovira Roure, St., 25198 Lleida, Spain.
| | - Judith Roca
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, St., 25198 Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, 80 Alcalde Rovira Roure, St., 25198 Lleida, Spain.
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Abstract
TOPIC This article presents an overview of the burden of peripheral intravenous catheter infections and current evidence-based recommendations for prevention. CLINICAL RELEVANCE Peripheral intravenous catheters are ubiquitous in most health care settings, fostering an acceptance of the peripheral intravenous catheter as benign and inevitable. This device, however, is far from benign, with reported failure rates as high as 90% from complications such as infection and phlebitis. Although reported rates of bloodstream infection related to peripheral intravenous catheters are much lower than those attributed to central venous catheters, the exponentially higher use of peripheral intravenous catheters indicates that the absolute number of peripheral venous catheter-related bloodstream infections is likely as high as and may surpass the number of central venous catheter-related bloodstream infections, with significant associated morbidity and mortality. PURPOSE OF PAPER Sustained improvements in outcomes related to peripheral intravenous catheters will depend on recognition of the root causes of failure and increased commitment to practice patterns consistent with infusion therapy standards of practice, effective education about peripheral intravenous catheters, accurate documentation of all aspects of peripheral intravenous catheter management, and consistent surveillance of patient outcomes related to peripheral intravenous catheters. CONTENT COVERED This article reviews the significant burden of peripheral intravenous catheter infections, barriers to effective peripheral intravenous catheter management, and current evidence-based recommendations to prevent this source of patient harm.
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Affiliation(s)
- Barb Nickel
- Barb Nickel is the critical care clinical nurse specialist for CHI Health St. Francis, Grand Island, Nebraska. She is a member of the Infusion Nurses Society Standards of Practice Committee
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13
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Measuring the Validity and Reliability of the Vascular Access Complication Staging and Treatment Instrument in a Pediatric Population. JOURNAL OF INFUSION NURSING 2021; 44:225-243. [PMID: 34197352 DOI: 10.1097/nan.0000000000000431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A multiphase study designed with Delphi and observational components was conducted to establish the preliminary validity and reliability of the 2018 Vascular Access Complication Staging and Treatment Instrument in pediatric and neonatal populations from a single, free-standing academic children's hospital. The instrument uses objective measurement criterion to determine the severity of swelling and tissue damage to inform treatment decisions. The results of the study provided preliminary empirical evidence to support a pediatric and neonatal intravenous complication staging instrument to assess degree of swelling and severity of tissue injury. The study also offered preliminary evidence that the instrument was perceived by the nurses who participated in the study to be efficient and easy to use.
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Guanche-Sicilia A, Sánchez-Gómez MB, Castro-Peraza ME, Rodríguez-Gómez JÁ, Gómez-Salgado J, Duarte-Clíments G. Prevention and Treatment of Phlebitis Secondary to the Insertion of a Peripheral Venous Catheter: A Scoping Review from a Nursing Perspective. Healthcare (Basel) 2021; 9:healthcare9050611. [PMID: 34069674 PMCID: PMC8160666 DOI: 10.3390/healthcare9050611] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 12/03/2022] Open
Abstract
The objective of this work was to identify available evidence on nursing interventions for the prevention and treatment of phlebitis secondary to the insertion of a peripheral venous catheter. For this, a scoping systematic review was carried out following the guidelines in the PRISMA declaration of documents published between January 2015 and December 2020. The search took place between December 2020 and January 2021. Scielo, Pubmed, Medline, Scopus, WOS, CINHAL, LILACS, and Dialnet databases were consulted, and CASPe, AGREE, and HICPAC tools were used for the critical reading. A total of 52 studies were included to analyze nursing interventions for treatment and prevention. Nursing interventions to prevent phlebitis and ensure a proper catheter use included those related to the maintenance of intravenous therapy, asepsis, and choosing the dressing. With regard to the nursing interventions to treat phlebitis, these were focused on vigilance and caring and also on the use of medical treatment protocols. For the prevention of phlebitis, the highest rated evidence regarding asepsis include the topical use of >0.5% chlorhexidine preparation with 70% alcohol or 2% aqueous chlorhexidine, a proper hygienic hand washing, and the use clean gloves to handle connections and devices. Actions that promote the efficacy and safety of intravenous therapy include maintenance of venous access, infusion volume control, verification of signs of phlebitis during saline solution and medication administration, and constant monitoring. It is recommended to remove any catheter that is not essential. Once discharged from hospital, it will be necessary to warn the patient about signs of phlebitis after PVC removal.
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Affiliation(s)
- Aitana Guanche-Sicilia
- University Hospital Nuestra Señora de Candelaria, Canary Islands Health Service, 38010 Tenerife, Spain;
| | - María Begoña Sánchez-Gómez
- University School of Nursing Nuestra Señora de Candelaria, University of La Laguna, 38001 Tenerife, Spain; (M.B.S.-G.); (M.E.C.-P.); (G.D.-C.)
| | - María Elisa Castro-Peraza
- University School of Nursing Nuestra Señora de Candelaria, University of La Laguna, 38001 Tenerife, Spain; (M.B.S.-G.); (M.E.C.-P.); (G.D.-C.)
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador
- Correspondence: ; Tel.: +34-959219700
| | - Gonzalo Duarte-Clíments
- University School of Nursing Nuestra Señora de Candelaria, University of La Laguna, 38001 Tenerife, Spain; (M.B.S.-G.); (M.E.C.-P.); (G.D.-C.)
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BIYIK BAYRAM Ş, EREN H, ÇALIŞKAN N. Kemoterapi Alan Hastalarda Ven Görünürlüğü ve Venöz Dolgunluğu Sağlayıcı Teknikler. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2021. [DOI: 10.33631/duzcesbed.732209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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16
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Manrique-Rodríguez S, Heras-Hidalgo I, Pernia-López MS, Herranz-Alonso A, Del Río Pisabarro MC, Suárez-Mier MB, Cubero-Pérez MA, Viera-Rodríguez V, Cortés-Rey N, Lafuente-Cabrero E, Martínez-Ortega MC, Bermejo-López E, Díez-Sáenz C, López-Sánchez P, Gaspar-Carreño ML, Achau-Muñoz R, Márquez-Peiró JF, Valera-Rubio M, Domingo-Chiva E, Aquerreta-González I, Ariño IP, Martín-Delgado MC, Herrera-Gutiérrez M, Gordo-Vidal F, Rascado-Sedes P, García-Prieto E, Fernández-Sánchez LJ, Fox-Carpentieri S, Lamela-Piteira C, Guerra-Sánchez L, Jiménez-Aguado M, Sanjurjo-Sáez M. Standardization and Chemical Characterization of Intravenous Therapy in Adult Patients: A Step Further in Medication Safety. Drugs R D 2021; 21:39-64. [PMID: 33346878 PMCID: PMC7937591 DOI: 10.1007/s40268-020-00329-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Intravenous drug administration is associated with potential complications, such as phlebitis. The physiochemical characteristics of the infusate play a very important role in some of these problems. AIM The aim of this study was to standardize the dilutions of intravenous drugs most commonly used in hospitalized adult patients and to characterize their pH, osmolarity and cytotoxic nature to better guide the selection of the most appropriate vascular access. METHODS The project was conducted in three phases: (i) standardization of intravenous therapy, which was conducted using a modified double-round Delphi method; (ii) characterization of the dilutions agreed on in the previous phase by means of determining the osmolarity and pH of each of the agreed concentrations, and recording the vesicant nature based on the information in literature; and (iii) algorithm proposal for selecting the most appropriate vascular access, taking into account the information gathered in the previous phases. RESULTS In total, 112 drugs were standardized and 307 different admixtures were assessed for pH, osmolarity and vesicant nature. Of these, 123 admixtures (40%), had osmolarity values >600 mOsm/L, pH < 4 or > 9, or were classified as vesicants. In these cases, selection of the most suitable route of infusion and vascular access device is crucial to minimize the risk of phlebitis-type complications. CONCLUSIONS Increasing safety of intravenous therapy should be a priority in the healthcare settings. Knowing the characteristics of drugs to assess the risk involved in their administration related to their physicochemical nature may be useful to guide decision making regarding the most appropriate vascular access and devices.
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Affiliation(s)
- Silvia Manrique-Rodríguez
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain.
| | - Irene Heras-Hidalgo
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Sagrario Pernia-López
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
| | - Ana Herranz-Alonso
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
| | - M Camino Del Río Pisabarro
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Nursing Department, Hospital Universitario Donostia, San Sebastián, Spain
| | - M Belén Suárez-Mier
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Nursing Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M Antonia Cubero-Pérez
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Nursing Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Verónica Viera-Rodríguez
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Nursing Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Noemí Cortés-Rey
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Nursing Department, Complejo Hospitalario Universitario A Coruña, La Coruña, Spain
| | - Elizabeth Lafuente-Cabrero
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Nursing Department, Hospital del Mar, Barcelona, Spain
| | - M Carmen Martínez-Ortega
- Sociedad Española de Infusión y Acceso Vascular (SEINAV), Madrid, Spain
- Preventive Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Esther Bermejo-López
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Díez-Sáenz
- Nursing Department (Intensive Care), Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Piedad López-Sánchez
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Hospital General de Tomelloso, Ciudad Real, Spain
| | - M Luisa Gaspar-Carreño
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Hospital Intermutual de Levante, Valencia, Spain
| | - Rubén Achau-Muñoz
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Hospital Intermutual de Levante, Valencia, Spain
| | - Juan F Márquez-Peiró
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Hospital Perpetuo Socorro, Alicante, Spain
| | - Marta Valera-Rubio
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Esther Domingo-Chiva
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Irene Aquerreta-González
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Ignacio Pellín Ariño
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Hospital de Torrejón de Ardoz, Madrid, Spain
| | - M Cruz Martín-Delgado
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Hospital de Torrejón de Ardoz, Madrid, Spain
| | - Manuel Herrera-Gutiérrez
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Federico Gordo-Vidal
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Hospital Universitario del Henares, Madrid, Spain
| | - Pedro Rascado-Sedes
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Complejo Hospitalario Universitario de Santiago de Compostela, La Coruña, Spain
| | - Emilio García-Prieto
- Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC), Madrid, Spain
- Intensive Care Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Sara Fox-Carpentieri
- Nursing Department, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
| | - Carlos Lamela-Piteira
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
- Pharmacy Department, Hospital Álvarez-Buylla, Mieres, Spain
| | - Luis Guerra-Sánchez
- Nursing Department (Coronary Unit), Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Miguel Jiménez-Aguado
- Nursing Department (Coronary Unit), Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Sanjurjo-Sáez
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, Spain
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da Silva DAF, Fernandes AA, Ventrone AE, Dias A, Silveira AMS, Santarém CL, Ribeiro GGDS, Nogueira RMB. The influence of low-fidelity simulator training on canine peripheral venous puncture procedure. Vet World 2021; 14:410-418. [PMID: 33776306 PMCID: PMC7994116 DOI: 10.14202/vetworld.2021.410-418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/04/2021] [Indexed: 11/19/2022] Open
Abstract
Background and Aim: Blood collection from dogs is the most commonly performed procedure in the medical clinic. However, different factors can interfere with the quality of the material collected, potentially causing complications for patients. Simulated skill training is a teaching strategy designed to provide early training to students, develop their skills and self-confidence, and increase the procedure’s success while reducing complications. Therefore, the aim of this study was to evaluate skill training using a low-fidelity simulator in the peripheral venipuncture procedure and examine the training’s influence on the in vivo procedure. Materials and Methods: To assess skill training, this study used a low-fidelity simulator in the peripheral venipuncture procedure and examines the training’s effect on the in vivo procedure. In total, 100 dogs, 65 undergraduate students, 3 veterinarians, and 4 previously trained evaluators participated. The canine in vivo venipuncture procedure was evaluated both before and after the simulated skill training and the low-fidelity simulator training. Data were collected on participants’ self-confidence levels. Results: Local complications occurred during in vivo practice; however, after training, they decreased. Gloves were more frequently used during the procedure, resulting in a reduction of both harvest attempts and complications, as well as increased levels of self-confidence in post-training participants. The simulator developed had low fidelity, low cost, and was easy to create. Conclusion: Skill training in peripheral venipuncture using a low-fidelity simulator positively influences student learning, increases their self-confidence during in vivo harvesting, and reduces the complications of the procedure, improving patient well-being.
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Affiliation(s)
- Dayane Aparecida Francisco da Silva
- Laboratory of Simulation and Skills Training in Veterinary Medicine, School of Agricultural Sciences, Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
| | - Aline Angela Fernandes
- Veterinary Medicine Undergraduate Program at Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
| | - Ana Evellyn Ventrone
- Veterinary Medicine Undergraduate Program at Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
| | - Ariane Dias
- Veterinary Medicine Undergraduate Program at Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
| | - Ana Maria Siqueira Silveira
- Department of Support and Diagnosis, Laboratory of Veterinary Clinical Pathology, Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
| | - Cecilia Laposy Santarém
- Department of Ph.D. Program in Pathophysiology and Animal Health, Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
| | | | - Rosa Maria Barilli Nogueira
- Department of Ph.D. Program in Pathophysiology and Animal Health, Universidade do Oeste Paulista, Presidente Prudente, Sao Paulo, Brazil
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Usability Assessment of an Innovative Device in Infusion Therapy: A Mix-Method Approach Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228335. [PMID: 33187193 PMCID: PMC7698130 DOI: 10.3390/ijerph17228335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022]
Abstract
Background: Flushing a venous access device is an important procedure to maintain their patency and prevent malfunctioning and complications. An innovative double-chamber syringe was developed, allowing for the assessment of catheter patency, drug delivery and final flush. This study aims to assess the usability of this new device, considering three development stages (concept, semi-functional prototype, functional prototype). Methods: An iterative methodology based on a mix-method design (qualitative and quantitative) enabled the assessment of the devices’ usability by their primary end-users. A usability questionnaire was developed and applied, along with focus groups and individual interviews to nurses. Results: The usability questionnaire integrated 42 items focused on four dimensions (usefulness; ease of use; ease of learning; satisfaction and intention to use). The initial psychometric findings indicate a good internal consistency and the conceptual relevance of the items. The scores seem to be sensitive to the usability evaluation of the medical devices in different stages of product development (with lower values on functional prototype evaluation), and related to nurses’ perceptions about functional and ergonomic characteristics. Conclusions: Quantitative and qualitative data provided a comprehensive overview of the double-chamber syringes’ usability from the nurses’ point of view, informing us of features that must be addressed.
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Carney M, Kearns T, Greene K. Collaborative strategic initiative between a university and hospital network group: Advanced nurse/midwife practice forum. J Nurs Manag 2020; 28:1457-1460. [PMID: 32667682 DOI: 10.1111/jonm.13099] [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: 04/14/2020] [Revised: 06/03/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Faculty of Nursing and Midwifery, one of a few nursing and midwifery faculties worldwide, was established in 1974 by Ms Mary Frances Crowley, for postgraduate nursing education, and is situated within the Royal College of Surgeons in Ireland, University of Medicine and Health Sciences. The RCSI operates through a network group of university hospitals: Beaumont, Connolly, Drogheda, Cavan, Monaghan and the Rotunda. Combined these hospitals have 120 registered and candidate ANP/AMPs and caters for general, psychiatric, children and maternity patients/clients. The drive to establish the forum between the faculty and the six Dublin hospitals was to build capacity among advanced nurse practitioners and advanced midwife practitioners (ANP/AMPs) who are seen as intelligent consumers of evidence-based research and safe practice. The SCAPE report identified research as the single domain that was underdeveloped within the ANP role, in the study exploring the role of ANPs and CNSs. Latterly, the Nursing and Midwifery Board of Ireland highlighted research as a vital component of the ANP/AMP role in its standards for advanced nurse and midwife practice. The faculty acted collaboratively to introduce an ANP/AMP forum to support advanced practitioners working in the university hospital group in their education and professional development, support the expansion of their knowledge base through practice-based enquiry and research and act as a conduit for interactions between ANPs/AMPs by keeping them up to date with practice and research. METHODS The Initiation phase was undertaken through a survey of needs; Implementation phase by extensive literature review and research-based newsletters sent to individuals by the forum coordinator; and the Evaluation phase through focus groups.
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Affiliation(s)
- Marie Carney
- Faculty of Nursing and Midwifery, RCSI Network Group Hospitals, Dublin, Ireland
| | - Thomas Kearns
- Faculty of Nursing and Midwifery, RCSI, Dublin, Ireland
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Goulart CB, Custódio CS, Vasques CI, Ferreira EB, Diniz dos Reis PE. Effectiveness of topical interventions to prevent or treat intravenous therapy‐related phlebitis: A systematic review. J Clin Nurs 2020; 29:2138-2149. [DOI: 10.1111/jocn.15266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/26/2020] [Accepted: 03/14/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Cristina B. Goulart
- Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology School of Health Sciences University of Brasília Brasília Brazil
| | - Carolina S. Custódio
- Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology School of Health Sciences University of Brasília Brasília Brazil
| | - Christiane I. Vasques
- Nursing Department Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology School of Health Sciences University of Brasília Brasília Brazil
| | - Elaine B. Ferreira
- Nursing Department Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology School of Health Sciences University of Brasília Brasília Brazil
| | - Paula E. Diniz dos Reis
- Nursing Department Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology School of Health Sciences University of Brasília Brasília Brazil
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Barth D, Sanchez A, Thomsen AM, Garcia A, Malachowski R, Weldon R, Mayhew M, Mudie K, Faller D, Schwartz J. Peripheral vascular access for therapeutic plasma exchange: A practical approach to increased utilization and selecting the most appropriate vascular access. J Clin Apher 2020; 35:178-187. [PMID: 32191358 DOI: 10.1002/jca.21778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/20/2020] [Accepted: 02/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Therapeutic plasma exchange (TPE) is used in the treatment of many diseases. At present, peripheral vascular access (PVA) is an underutilized method of vascular access in TPE. It should be considered more frequently due its relatively low risk for adverse events, particularly infections. METHODS The Advancing Vascular Access in Apheresis Working Group met in December 2017 for an extensive review and discussion of vascular access for TPE and developed a "road map" providing detailed information regarding clinical situations in which PVA-based TPE would and would not be appropriate. RESULTS The road map is consistent with current recommendations that PVA should be used in combination with TPE whenever possible. PVA should be considered for patients who do not have existing central lines and who are stable. The patient should have peripheral veins that will allow for adequate treatment and must be able to comply with the process of achieving and maintaining peripheral access. There should be expert clinical assessment of veins, and this evaluation may include ultrasound and/or near infrared evaluation. Conditions that would prompt a switch from PVA to an alternate method of venous access include loss of venous access, patient preference, or development of a requirement for very frequent treatment over a long period of time. CONCLUSIONS While PVA is not suitable for all patients requiring TPE, it has significant safety advantages over other approaches and should be employed whenever possible.
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Affiliation(s)
- David Barth
- Department of Laboratory Medicine and Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Amber Sanchez
- Department of Medicine, University of California, San Diego, California, USA
| | - Anna-Marie Thomsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Alicia Garcia
- USCF Children's Hospitals, Oakland and San Francisco, California, USA
| | - Roman Malachowski
- Department of Hematology, Copernicus Memorial Hospital, Łódź, Poland
| | - Rebecca Weldon
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Kari Mudie
- Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
| | | | - Joseph Schwartz
- Colombia University Medical Centre, New York City, New York, USA
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Pérez-Granda MJ, Bouza E, Pinilla B, Cruces R, González A, Millán J, Guembe M. Randomized clinical trial analyzing maintenance of peripheral venous catheters in an internal medicine unit: Heparin vs. saline. PLoS One 2020; 15:e0226251. [PMID: 31905205 PMCID: PMC6944354 DOI: 10.1371/journal.pone.0226251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/12/2019] [Indexed: 01/28/2023] Open
Abstract
Background Peripheral venous catheters (PVCs) require adequate maintenance based on heparin or saline locks in order to prevent complications. Heparin has proven effective in central venous catheters, although its use in PVCs remains controversial. Our hypothesis was that saline locks are as effective as heparin locks in preventing problems with PVCs. The objective of the present study was to compare phlebitis and catheter tip colonization rates between PVCs locked with saline and those locked with heparin in patients admitted to an internal medicine department (IMD). Methods We performed a 19-month prospective, controlled, open-label, randomized clinical study of patients with at least 1 PVC admitted to the IMD of our hospital. The patients were randomized to receive saline solution (PosiFlush®, group A) or heparin (Fibrilin®, group B) for daily maintenance of the PVC. Clinical and microbiological data were monitored to investigate the frequency of phlebitis, catheter tip colonization, and catheter-related bloodstream infection (C-RBSI), as well as crude mortality, days of hospital stay, and days of antimicrobial treatment. Results We assessed 339 PVCs (241 patients), of which 192 (56.6%) were locked with saline (group A) and 147 (43.4%) with heparin (group B). The main demographic characteristics of the patients were distributed equally between the 2 study groups. The median (IQR) catheter days was 5 (3–8) for both groups (p = 0.64). The frequency of phlebitis was 17.7% for group A and 13.3% for group B (p = 0.30). The frequency of colonization of PVC tips was 14.6% and 12.2% in groups A and B, respectively (p = 0.63). Only 2 episodes of C-RBSI were detected (1 patient in group A). Saline lock was not an independent factor for phlebitis or catheter colonization. Conclusions Our study revealed no statistically significant differences in the frequency of phlebitis and catheter tip colonization between PVCs locked with saline and PVCs locked with heparin. We suggest that PVC can be maintained with saline solution, as it is safer and cheaper than heparin.
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Affiliation(s)
- María Jesús Pérez-Granda
- Department of Clinical Microbiology and Infectious Diseases, H.G.U. Gregorio Marañón, Madrid, Spain
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
- * E-mail: (MG); (MJP-G)
| | - Emilio Bouza
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Infection Study Group of the Sociedad Española de Medicina Interna, Madrid, Spain
| | - Blanca Pinilla
- Infection Study Group of the Sociedad Española de Medicina Interna, Madrid, Spain
- Department of Internal Medicine, H.G.U. Gregorio Marañón, Madrid, Spain
| | - Raquel Cruces
- Department of Clinical Microbiology and Infectious Diseases, H.G.U. Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ariana González
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Jesús Millán
- Department of Internal Medicine, H.G.U. Gregorio Marañón, Madrid, Spain
| | - María Guembe
- Department of Clinical Microbiology and Infectious Diseases, H.G.U. Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- * E-mail: (MG); (MJP-G)
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Cost-Effectiveness Analysis of Low-Cost, Domestic Short Peripheral Catheters Versus Higher-Priced, Imported Short Peripheral Catheters. JOURNAL OF INFUSION NURSING 2019; 42:209-214. [PMID: 31283664 DOI: 10.1097/nan.0000000000000336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This prospective study has been designed with the hypothesis that low unit price does not necessarily mean cost-effectiveness. Low-cost, domestic short peripheral catheters (SPCs) and higher-priced, imported SPCs were compared in 2 different time periods. With the use of the higher-priced, imported SPCs, the rate of successful insertion on first attempt was increased (P < .001), and the development of complications was reduced (P < .001). The study revealed that $345 was saved per 1000 catheters when the catheter with the higher unit price was chosen. Although the domestic SPCs had a low unit price, their use resulted in greater health care expenses.
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Borrhomée S, Merbouche S, Kern-Duciau N, Boize P. Umbilical vein catheterization through Wharton's jelly: A possibility for a fast and safe way to deliver treatments in the delivery room? Arch Pediatr 2019; 26:381-384. [PMID: 31285106 DOI: 10.1016/j.arcped.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/02/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
Fast and safe venous access can be a critical issue in the delivery room during neonatal cardiopulmonary resuscitation or before endotracheal intubation. Here, we describe a new method to inject drugs using the umbilical vein, directly punctured through Wharton's jelly, performed in ten newborns between November 2016 and May 2018. The umbilical vein was identified and punctured easily and a reflux was obtained in all patients. The treatments were efficient in all but two patients, which was imputable to the method in one patient. We describe a new route for administration of drugs that has been successfully used in neonates.
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Affiliation(s)
- S Borrhomée
- Neonatal Intensive Care Unit of Pontoise, Hospital René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France.
| | - S Merbouche
- Neonatal Intensive Care Unit of Pontoise, Hospital René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France
| | - N Kern-Duciau
- Neonatal Intensive Care Unit of Pontoise, Hospital René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France
| | - P Boize
- Neonatal Intensive Care Unit of Pontoise, Hospital René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France
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Ritzenthaler T, Beraud M, Gobert F, Dailler F. Influence of vascular access devices upon efficiency of therapeutic plasma exchange. J Clin Apher 2018; 34:33-38. [DOI: 10.1002/jca.21669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Thomas Ritzenthaler
- Service de Réanimation Neurologique; Hospices civils de Lyon; Bron Cedex France
| | | | - Florent Gobert
- Service de Réanimation Neurologique; Hospices civils de Lyon; Bron Cedex France
| | - Frédéric Dailler
- Service de Réanimation Neurologique; Hospices civils de Lyon; Bron Cedex France
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