Quality of Life, Pain Perception, and Distress Correlated to Ultrasound-Guided Peripherally Inserted Central Venous Catheters in Palliative Care Patients in a Home or Hospice Setting.

CONTEXT: Intravenous fluid administration with peripherally inserted central venous catheters (PICCs) and midline catheters in palliative care. OBJECTIVES: To evaluate distress and pain perceived by patients during the positioning of a PICC or midline catheter, both in the home and hospice settings. METHODS: This was a prospective observational study performed by the Palliative Care Network of Pordenone. In addition to evaluating distress and pain, we monitored patient quality of life and the devices used. Quality of life was measured with the European Organization for Research and Treatment of Cancer-Core 15-Palliative scale. RESULTS: From May 2012 to July 2013, 48 patients were enrolled in the study. The level of distress during the procedure was null or very low in 95.8% of the patients and completely absent after one week. Pain during insertion was null or very little in 93.8% of the patients and zero after one week in 98% of the patients. Quality of life was significantly improved after one week for certain specific parameters and also globally. The number of catheter days monitored was 3097. The weekly monitoring of the devices revealed a series of minor complications. Only two catheters were removed for serious complications. CONCLUSION: Our results showed a low impact on pain and distress, a low level of local and systemic complications and a favorable impact on patients' quality of life. However, other studies are necessary to evaluate the cost-effectiveness of the use of these devices and their role in palliative care.

[LARS Research Project. Nursing Research Laboratory of the Health Regional Agency of the Friuli Venezia Giulia Region. Observational study on the outcomes of organizative models of medical wards on nurses, patients and organization]. / Progetto di Ricerca LARS (Laboratorio di Ricerca Infermieristica Agenzia Regionale alla Sanità, Friuli Venezia Giulia). Studio osservazionale sugli esiti dei modelli organizzativi assistenziali delle medicine, su infermieri, su pazienti ed organizzazione.

UNLABELLED: No large scale studies have been conducted in Italy to assess factors that influence hospital nurses' satisfaction. AIMS: To explore the relationship between participative organizative models and outcomes on nurses (work satisfaction, burnout, intention to stay), patients (satisfaction with quality of care) and organization (nurses turnover). MATERIALS AND METHODS: This multicentre regional study involves 20 acute medical wards and more than 500 nurses. Data on the organizative model adopted in the ward will be collected with an ad hoc questionnaire with scores from 7 (scarce-limited involvement of nurses in decision making) to 35 (nurses take decisions on the management of the ward). Nurses satisfaction with their work is measured with the Nursing Work Index Revised; burnout with the Maslack Burnout Inventory; patients satisfaction with the Experiences of Nursing Care Scale Newcastle Satisfaction with Nursing Scale. The outcomes considered for the organization will be turnover, absences from work, injuries. RESULTS: The study is ongoing. The association of each outcome to the organizzative model will be explored. Multivariate regression model will be adjusted for casemix index of the previuos year. T test and chi square tests will be used and a p value of 0.05 will be considered significant.