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Rosich-Soteras A, Bonilla-Serrano C, Llauradó-González MÀ, Fernández-Bombín A, Triviño-López JA, Barceló-Querol L, Heredia-Aguilar L, Frías-Martín MC, Valverde-Bosch M, Corominas-Bosch ML, Domènech A. Implementation of a vascular access team and an intravenous therapy programme: A first-year activity analysis. J Vasc Access 2024:11297298231220537. [PMID: 38205609 DOI: 10.1177/11297298231220537] [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: 01/12/2024] Open
Abstract
BACKGROUND Creating Vascular Access Teams (VAT) provides an expert nursing role that contributes to the training and continuous improvement of healthcare personnel. They can offer greater clinical safety, reducing complications and costs. Peripherally inserted central catheters (PICCs) and midline catheters (ML) can be safe and cost-effective alternatives to other types of venous access (VA). The aim of the study was to analyse our centre's VAT first 12 months of activity. The primary outcome was reported complications. Secondary outcomes were cause of catheter removal, consultancy activity and economic impact of VAT implantation. METHODOLOGY A longitudinal, descriptive study was carried out from March 2019 to March 2020. Using consecutive sampling, all VA inserted, and all consults received were included. Patients under 18 years of age were excluded. RESULTS The VAT inserted 1257 catheters into 1056 patients (291 MLs, 966 PICCs). The mean dwell time was 14.9 days for MLs and 59.07 days for PICCs. The main reason for removing VA was end of treatment (80.7%). During VA follow-up confirmed infection was detected in 1 ML (0.3%) and nine PICCs (0.9%). Symptomatic thrombosis was reported in 2 MLs (0.7%) and 16 PICCs (1.7%). The VAT received 367 consultations, and the main reason for consultation was to resolve doubts regarding the management of VA (80.9%). The insertion of ML and PICC catheters represented annual estimated economic savings of €867,688.44€. CONCLUSIONS Our study provides a detailed analysis of VAT's activity, its relevance to clinical safety, and to efficient resource management within our hospital. It demonstrates how VAT establishment can be a safe and efficient intervention that enhances care quality.
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Affiliation(s)
| | | | | | | | | | | | - Laura Heredia-Aguilar
- Trauma and Orthopaedic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Ma Carmen Frías-Martín
- Gastroenterology and Digestive Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | | | | | - Ariadna Domènech
- Oncology and Haematology Department, Hospital Clínic Barcelona, Barcelona, Spain
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Ribeiro GDSR, Campos JF, Camerini FG, Parreira PMSD, da Silva RC. Flushing in Intravenous Catheters: Observational Study of Nursing Practice in Intensive Care in Brazil. JOURNAL OF INFUSION NURSING 2023; 46:272-280. [PMID: 37611285 DOI: 10.1097/nan.0000000000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
An observational study was developed with 108 nursing professionals who managed vascular access devices in 4 intensive care units of a university hospital in Rio de Janeiro, Brazil. The objective was to analyze the practice of the nursing staff in performing flushing for the maintenance of vascular access devices in critically ill patients. Data were collected by observing the flushing procedure using a structured checklist and analyzed using descriptive and inferential statistics. In 23% of the 404 observations, there was no flushing. When performed at some point during catheter management (77%), flushing was predominant after drug administration with 1 or 2 drugs administered. There were flaws in the flushing technique applied in terms of volume and method of preparation. Time of professional experience >5 years, knowledge about recommendations, and training on flushing were variables associated with technique performance. It was concluded that the flushing procedure did not meet the recommendations of good practices, with failures that constituted medication errors.
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Affiliation(s)
- Gabriella da Silva Rangel Ribeiro
- Gabriella da Silva Rangel Ribero, RN, is a PhD candidate in nursing, Anna Nery School of Nursing, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. She is a specialist in intensive care nursing from the State University of Rio de Janeiro and member of the research group "Representations and Practices of Health Care and Nursing." Ms da Silva Rangel Ribero is a nurse in the area of health policies at the United Health Group with clinical experience in the area of Intensive Care Nursing, with publications and research interests focused on the themes of health technology, patient safety, and infusion therapy
- Juliana Faria Campos, PhD, is an associate professor at Anna Nery School of Nursing, UFRJ, and leader of the research group "Technologies and Conceptions for the Systematization of Nursing Care." She is coordinator of the multiuser Skills Laboratory of the Health Sciences Center at the Federal University of Rio de Janeiro and permanent professor of the Graduate Program in Nursing of the Anna Nery School of Nursing, UFRJ (Masters and PhD), with research projects and publications on the themes of clinical simulation, intensive care, and patient safety. Dr Faria Campos is also a reviewer of scientific journals and has clinical experience in intensive care nursing
- Flávia Giron Camerini, PhD, is an associate professor at the School of Nursing of the State University of Rio de Janeiro (UERJ), and leader of the research group "Health Technology and Nursing in the Context of Patient Safety in the Hospital Environment." She is a member of the Scientific Committee of the Brazilian Society of Quality and Patient Safety and permanent professor of the graduate program at the School of Nursing of UERJ (Master's and PhD). Dr Giron Camerini is associate editor of the Brazilian journal, Texto e Contexto Enfermagem, and ad hoc reviewer for various scientific journals. She has clinical experience in intensive care nursing, with several research projects and publications on drug therapy safety
- Pedro Miguel Santos Dinis Parreira, PhD, is a researcher at the Health Sciences/Nursing Research Unit of the Nursing School of Coimbra, Portugal. He is coordinator of the Entrepreneurship Office of the Nursing School of Coimbra and coordinates several funded research projects and has several international publications on the development of technologies and innovations for professional practice in nursing and on entrepreneurship
- Rafael Celestino da Silva, PhD, is an associate professor at Anna Nery School of Nursing, Federal UFRJ, and leader of the research group "Representations and Practices of Health Care and Nursing." Dr Celestino da Silva is a permanent professor at the graduate program of the Anna Nery School of Nursing at UFRJ (Master's and PhD), with several research projects and publications on care technologies, professional practices, and patient safety in the context of intensive care. He is an editor at the Brazilian Journal of Nursing, ad hoc reviewer of several scientific journals, and has clinical experience in the area of Medical-Surgical Nursing
| | - Juliana Faria Campos
- Gabriella da Silva Rangel Ribero, RN, is a PhD candidate in nursing, Anna Nery School of Nursing, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. She is a specialist in intensive care nursing from the State University of Rio de Janeiro and member of the research group "Representations and Practices of Health Care and Nursing." Ms da Silva Rangel Ribero is a nurse in the area of health policies at the United Health Group with clinical experience in the area of Intensive Care Nursing, with publications and research interests focused on the themes of health technology, patient safety, and infusion therapy
- Juliana Faria Campos, PhD, is an associate professor at Anna Nery School of Nursing, UFRJ, and leader of the research group "Technologies and Conceptions for the Systematization of Nursing Care." She is coordinator of the multiuser Skills Laboratory of the Health Sciences Center at the Federal University of Rio de Janeiro and permanent professor of the Graduate Program in Nursing of the Anna Nery School of Nursing, UFRJ (Masters and PhD), with research projects and publications on the themes of clinical simulation, intensive care, and patient safety. Dr Faria Campos is also a reviewer of scientific journals and has clinical experience in intensive care nursing
- Flávia Giron Camerini, PhD, is an associate professor at the School of Nursing of the State University of Rio de Janeiro (UERJ), and leader of the research group "Health Technology and Nursing in the Context of Patient Safety in the Hospital Environment." She is a member of the Scientific Committee of the Brazilian Society of Quality and Patient Safety and permanent professor of the graduate program at the School of Nursing of UERJ (Master's and PhD). Dr Giron Camerini is associate editor of the Brazilian journal, Texto e Contexto Enfermagem, and ad hoc reviewer for various scientific journals. She has clinical experience in intensive care nursing, with several research projects and publications on drug therapy safety
- Pedro Miguel Santos Dinis Parreira, PhD, is a researcher at the Health Sciences/Nursing Research Unit of the Nursing School of Coimbra, Portugal. He is coordinator of the Entrepreneurship Office of the Nursing School of Coimbra and coordinates several funded research projects and has several international publications on the development of technologies and innovations for professional practice in nursing and on entrepreneurship
- Rafael Celestino da Silva, PhD, is an associate professor at Anna Nery School of Nursing, Federal UFRJ, and leader of the research group "Representations and Practices of Health Care and Nursing." Dr Celestino da Silva is a permanent professor at the graduate program of the Anna Nery School of Nursing at UFRJ (Master's and PhD), with several research projects and publications on care technologies, professional practices, and patient safety in the context of intensive care. He is an editor at the Brazilian Journal of Nursing, ad hoc reviewer of several scientific journals, and has clinical experience in the area of Medical-Surgical Nursing
| | - Flávia Giron Camerini
- Gabriella da Silva Rangel Ribero, RN, is a PhD candidate in nursing, Anna Nery School of Nursing, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. She is a specialist in intensive care nursing from the State University of Rio de Janeiro and member of the research group "Representations and Practices of Health Care and Nursing." Ms da Silva Rangel Ribero is a nurse in the area of health policies at the United Health Group with clinical experience in the area of Intensive Care Nursing, with publications and research interests focused on the themes of health technology, patient safety, and infusion therapy
- Juliana Faria Campos, PhD, is an associate professor at Anna Nery School of Nursing, UFRJ, and leader of the research group "Technologies and Conceptions for the Systematization of Nursing Care." She is coordinator of the multiuser Skills Laboratory of the Health Sciences Center at the Federal University of Rio de Janeiro and permanent professor of the Graduate Program in Nursing of the Anna Nery School of Nursing, UFRJ (Masters and PhD), with research projects and publications on the themes of clinical simulation, intensive care, and patient safety. Dr Faria Campos is also a reviewer of scientific journals and has clinical experience in intensive care nursing
- Flávia Giron Camerini, PhD, is an associate professor at the School of Nursing of the State University of Rio de Janeiro (UERJ), and leader of the research group "Health Technology and Nursing in the Context of Patient Safety in the Hospital Environment." She is a member of the Scientific Committee of the Brazilian Society of Quality and Patient Safety and permanent professor of the graduate program at the School of Nursing of UERJ (Master's and PhD). Dr Giron Camerini is associate editor of the Brazilian journal, Texto e Contexto Enfermagem, and ad hoc reviewer for various scientific journals. She has clinical experience in intensive care nursing, with several research projects and publications on drug therapy safety
- Pedro Miguel Santos Dinis Parreira, PhD, is a researcher at the Health Sciences/Nursing Research Unit of the Nursing School of Coimbra, Portugal. He is coordinator of the Entrepreneurship Office of the Nursing School of Coimbra and coordinates several funded research projects and has several international publications on the development of technologies and innovations for professional practice in nursing and on entrepreneurship
- Rafael Celestino da Silva, PhD, is an associate professor at Anna Nery School of Nursing, Federal UFRJ, and leader of the research group "Representations and Practices of Health Care and Nursing." Dr Celestino da Silva is a permanent professor at the graduate program of the Anna Nery School of Nursing at UFRJ (Master's and PhD), with several research projects and publications on care technologies, professional practices, and patient safety in the context of intensive care. He is an editor at the Brazilian Journal of Nursing, ad hoc reviewer of several scientific journals, and has clinical experience in the area of Medical-Surgical Nursing
| | - Pedro Miguel Santos Dinis Parreira
- Gabriella da Silva Rangel Ribero, RN, is a PhD candidate in nursing, Anna Nery School of Nursing, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. She is a specialist in intensive care nursing from the State University of Rio de Janeiro and member of the research group "Representations and Practices of Health Care and Nursing." Ms da Silva Rangel Ribero is a nurse in the area of health policies at the United Health Group with clinical experience in the area of Intensive Care Nursing, with publications and research interests focused on the themes of health technology, patient safety, and infusion therapy
- Juliana Faria Campos, PhD, is an associate professor at Anna Nery School of Nursing, UFRJ, and leader of the research group "Technologies and Conceptions for the Systematization of Nursing Care." She is coordinator of the multiuser Skills Laboratory of the Health Sciences Center at the Federal University of Rio de Janeiro and permanent professor of the Graduate Program in Nursing of the Anna Nery School of Nursing, UFRJ (Masters and PhD), with research projects and publications on the themes of clinical simulation, intensive care, and patient safety. Dr Faria Campos is also a reviewer of scientific journals and has clinical experience in intensive care nursing
- Flávia Giron Camerini, PhD, is an associate professor at the School of Nursing of the State University of Rio de Janeiro (UERJ), and leader of the research group "Health Technology and Nursing in the Context of Patient Safety in the Hospital Environment." She is a member of the Scientific Committee of the Brazilian Society of Quality and Patient Safety and permanent professor of the graduate program at the School of Nursing of UERJ (Master's and PhD). Dr Giron Camerini is associate editor of the Brazilian journal, Texto e Contexto Enfermagem, and ad hoc reviewer for various scientific journals. She has clinical experience in intensive care nursing, with several research projects and publications on drug therapy safety
- Pedro Miguel Santos Dinis Parreira, PhD, is a researcher at the Health Sciences/Nursing Research Unit of the Nursing School of Coimbra, Portugal. He is coordinator of the Entrepreneurship Office of the Nursing School of Coimbra and coordinates several funded research projects and has several international publications on the development of technologies and innovations for professional practice in nursing and on entrepreneurship
- Rafael Celestino da Silva, PhD, is an associate professor at Anna Nery School of Nursing, Federal UFRJ, and leader of the research group "Representations and Practices of Health Care and Nursing." Dr Celestino da Silva is a permanent professor at the graduate program of the Anna Nery School of Nursing at UFRJ (Master's and PhD), with several research projects and publications on care technologies, professional practices, and patient safety in the context of intensive care. He is an editor at the Brazilian Journal of Nursing, ad hoc reviewer of several scientific journals, and has clinical experience in the area of Medical-Surgical Nursing
| | - Rafael Celestino da Silva
- Gabriella da Silva Rangel Ribero, RN, is a PhD candidate in nursing, Anna Nery School of Nursing, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. She is a specialist in intensive care nursing from the State University of Rio de Janeiro and member of the research group "Representations and Practices of Health Care and Nursing." Ms da Silva Rangel Ribero is a nurse in the area of health policies at the United Health Group with clinical experience in the area of Intensive Care Nursing, with publications and research interests focused on the themes of health technology, patient safety, and infusion therapy
- Juliana Faria Campos, PhD, is an associate professor at Anna Nery School of Nursing, UFRJ, and leader of the research group "Technologies and Conceptions for the Systematization of Nursing Care." She is coordinator of the multiuser Skills Laboratory of the Health Sciences Center at the Federal University of Rio de Janeiro and permanent professor of the Graduate Program in Nursing of the Anna Nery School of Nursing, UFRJ (Masters and PhD), with research projects and publications on the themes of clinical simulation, intensive care, and patient safety. Dr Faria Campos is also a reviewer of scientific journals and has clinical experience in intensive care nursing
- Flávia Giron Camerini, PhD, is an associate professor at the School of Nursing of the State University of Rio de Janeiro (UERJ), and leader of the research group "Health Technology and Nursing in the Context of Patient Safety in the Hospital Environment." She is a member of the Scientific Committee of the Brazilian Society of Quality and Patient Safety and permanent professor of the graduate program at the School of Nursing of UERJ (Master's and PhD). Dr Giron Camerini is associate editor of the Brazilian journal, Texto e Contexto Enfermagem, and ad hoc reviewer for various scientific journals. She has clinical experience in intensive care nursing, with several research projects and publications on drug therapy safety
- Pedro Miguel Santos Dinis Parreira, PhD, is a researcher at the Health Sciences/Nursing Research Unit of the Nursing School of Coimbra, Portugal. He is coordinator of the Entrepreneurship Office of the Nursing School of Coimbra and coordinates several funded research projects and has several international publications on the development of technologies and innovations for professional practice in nursing and on entrepreneurship
- Rafael Celestino da Silva, PhD, is an associate professor at Anna Nery School of Nursing, Federal UFRJ, and leader of the research group "Representations and Practices of Health Care and Nursing." Dr Celestino da Silva is a permanent professor at the graduate program of the Anna Nery School of Nursing at UFRJ (Master's and PhD), with several research projects and publications on care technologies, professional practices, and patient safety in the context of intensive care. He is an editor at the Brazilian Journal of Nursing, ad hoc reviewer of several scientific journals, and has clinical experience in the area of Medical-Surgical Nursing
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Baye ND, Teshome AA, Ayenew AA, Amare TJ, Mulu AT, Abebe EC, Tiruneh GA, Ayele TM, Muche ZT, Teklemariam AB, Melese BD, Agidew MM, Seid MA. Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study. BMC Nurs 2023; 22:11. [PMID: 36631864 PMCID: PMC9832806 DOI: 10.1186/s12912-022-01164-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Peripheral intravenous cannulas (PIVC) are venous access devices commonly used for the administration of intravenous fluids, drugs, blood products, and parenteral nutrition. Despite its frequent use, it has complications that can seriously threaten patient safety, prolong hospital stays, and increases medical care costs. PIVC complications are associated with increased morbidity and reinsertion attempts are painful and anxiety-provoking for children and their parents. Therefore, this study was aimed to assess the incidence, time to occurrence and identify predictors for PIVC complications among infants admitted to Debre Tabor Comprehensive Specialized Hospital (DTCSH), Northwest Ethiopia. METHODS AND SETTING An institutional-based prospective cohort study was conducted on 358 infants admitted to a neonatal intensive care unit and pediatric ward, DTCSH from January 1 to April 30, 2022. A systematic sampling technique was employed. RESULTS The incidence rate of PIVC complication was 11.6 per 1000 person-hours observation. PIVC complication was observed in 56.4% (202) of PIVCs, of which infiltration (42.1%) was the most common complication followed by phlebitis (29.7%). The median time to complication was 46 h. Anatomical insertion site (AHR = 2.85, 95%CI: 1.63-6.27), admission unit (AHR = 1.88, 95%CI: 1.07-4.02), sickness (AHR = 0.24, 95% CI: 1.31-4.66), medication type (AHR = 2.04, 95%CI: 1.13-3.66), blood transfusion (AHR = 0.79, 95%CI: 0.02-0.99), clinical experience (AHR = 0.52, CI:0.26-0.84), and flushing (AHR = 0.71, 95%CI: 0.34-0.98) were potential predictors of PIVC complication. CONCLUSION Knowing the predictor factors helps clinicians to provide effective care and to detect complications early.
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Affiliation(s)
- Nega Dagnew Baye
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Assefa Agegnehu Teshome
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Atalo Agimas Ayenew
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tadeg Jemere Amare
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anmut Tilahun Mulu
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gebrehiwot Ayalew Tiruneh
- grid.510430.3Department of Clinical Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Teklie Mengie Ayele
- grid.510430.3Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Zelalem Tilahun Muche
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Awgichew Behaile Teklemariam
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Biruk Demissie Melese
- grid.510430.3Department of Environmental Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melaku Mekonnen Agidew
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- grid.510430.3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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