RESUMEN
Intravenous infusion is an important route of drug therapy, and infusion safety is an important issue for medical staff. Long-term and multiple infusion routes at the same time bring inconvenience to patients. Multiple three-way switches in parallel infusion may lead to interruption of the liquid route, which can seriously endanger the life of patients. To address these clinical issues, medical staff from the School of Basic Medical Sciences of Hebei Medical University and the Emergency Department of the Second Hospital of Hebei Medical University designed a multiple combination portable infusion assistance device and obtained the National Utility Model Patent of China (ZL 2022 2 0226073.2). The device is mainly composed of adhesive tape sticker, fixed slots and pipelines, and also includes a three-way valve and a mixing chamber, and different modes of infusion assist devices can be selected according to clinical needs. The device is simple and convenient to operate, solves the problem of multiple liquid infusion blockages, improves the safety and comfort of infusion, and can meet the needs of liquid infusion in various clinical situations.
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Diseño de Equipo , Humanos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/métodos , Bombas de InfusiónRESUMEN
RATIONALE AND KEY POINTS: This article explains how to prepare and administer an intravenous (IV) infusion using a gravity administration (giving) set or a volumetric pump in a safe, effective manner. Nurses undertaking this procedure must ensure they have the knowledge and skills to do so and work within the limits of their competence. This article serves as a revision of best practice in administering IV infusions of fluids and medicines. ⢠IV infusions are delivered directly into the bloodstream, so care must be taken to protect the patient from harm by following the appropriate policies and protocols and monitoring the patient carefully for adverse reactions. ⢠There is a risk of administering large volumes of IV fluid to the patient when using a gravity administration set, so a burette or volumetric pump should be used in patients who may not tolerate this. ⢠Volumetric pumps vary, so it is essential that the nurse is familiar with the device, uses the specific administration set required and follows the manufacturer's instructions. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: ⢠How this article might improve your practice when preparing and administering an IV infusion. ⢠How you could use this information to educate nursing students or your colleagues on the appropriate methods for preparing and administering an IV infusion.
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Bombas de Infusión , Infusiones Intravenosas/métodos , Infusiones Intravenosas/instrumentación , Humanos , Reino Unido , Gravitación , Competencia ClínicaRESUMEN
INTRODUCTION: The absence of a consistent downward G vector can make separation of gases from liquids challenging, such as in field medicine without stable upright equipment or during spaceflight. This limits the use of medical equipment and procedures like administration of intravenous (IV) fluids in microgravity and can make field medicine hazardous. Administering IV fluids and medications in microgravity requires a technique to separate air from the liquid phase. Current commercial filters for separation of gases are incompatible with high flow and blood. We present a novel filter designed to provide adequate air clearance without a consistent downward G vector.METHODS: Inline air-eliminating filters were designed for use with IV fluid tubing in microgravity using computer-aided design software and printed using nylon 12 on an EOS Selective Laser Sintering 3D printer. A 0.2-µm membrane filter was adhered around a central, hollow pillar with external spiral baffles allowing separation and venting of air from the fluid. Results were compared against commercially available inline air-eliminating filters.RESULTS: The 3D-printed filters outperformed the commercial filters in both percentage of air removed and flow rates. The centrifugal, baffled filter had flow rates that far exceeded the commercial filters during rapid transfusion.DISCUSSION: IV fluid administration is an often underappreciated and a necessary basic requirement for medical treatment. An air-eliminating filter compatible with blood and rapid transfusion was developed and validated with crystalloid solutions to allow the successful administration of IV fluid and medication without a consistent downward G vector.Formanek A, Townsend J, Ottensmeyer MP, Kamine TH. A novel 3D-printed gravity-independent air-eliminating filter for rapid intravenous infusions. Aerosp Med Hum Perform. 2024; 95(6):327-332.
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Diseño de Equipo , Impresión Tridimensional , Humanos , Infusiones Intravenosas/instrumentación , Filtración/instrumentación , Medicina Aeroespacial , Ingravidez , Gravitación , Diseño Asistido por ComputadoraRESUMEN
In 2017, a severe shortage of infusion bags resulted in a paradigm change in medication administration practice from intermittent infusion to intravenous push. The Institute for Safe Medication Practices proposed safe practice guidelines for adult intravenous push medications. A different study showed that ready-to-administer medication prepared in the sterile area of a pharmacy reduces the risk of harm, nurses' time for medication administration and the cost of medications. Based on the recommendation of the Institute for Safe Medication Practices, we decided to conduct a pilot study on the implementation of sterile compounding and administration of intravenous push medication in adult patients admitted to the hospital. In the study, the stability of five intravenous push antibiotic syringes was also determined in the syringes.
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Antibacterianos , Jeringas , Centros de Atención Terciaria , Humanos , Jeringas/normas , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Centros de Atención Terciaria/organización & administración , Centros de Atención Terciaria/estadística & datos numéricos , Proyectos Piloto , Adulto , Administración Intravenosa/métodos , Estabilidad de Medicamentos , Infusiones Intravenosas/métodos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/normasRESUMEN
Intravenous infusion flow regulators (IIFRs) are widely used devices but it is unknown how much the difference between the IIFR scale and the actual flow rate depends on the viscosity of the intravenous (IV) fluid. This study evaluated the effects of viscosity on the flow rate of five IV fluids (0.9% normal saline, Hartmann's solution, plasma solution-A, 6% hetastarch, and 5% albumin) when using IIFRs. The viscosity of crystalloids was 1.07-1.12 mPa·s, and the viscosities of 6% hetastarch and 5% albumin were 2.59 times and 1.74 times that of normal saline, respectively. When the IIFR scales were preset to 20, 100, and 250 mL/hr, crystalloids were delivered at the preset flow rate within a difference of less than 10%, while 6% hetastarch was delivered at approximately 40% of the preset flow rates and 5% albumin was approximately 80% transmitted. When delivering colloids, IIFRs should be used with caution.
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Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/normas , Viscosidad , Líquidos Corporales , FluidoterapiaRESUMEN
Background: We investigated the extent of growth of microorganisms with simultaneous administration of lipid emulsions with infusions for Total Parenteral Nutrition (TPN), assuming that the lipid emulsions contaminated with microorganisms are stagnant in a closed-type infusion device. We also investigated if bacterial growth can be prevented in the infusion device by flushing the inside of the infusion device with saline solution after the administration of lipid emulsion from the side tube in vitro setting. Methods: We made a preparation by adding Escherichia coli to the lipid emulsion and started the infusion simultaneously with the infusion solution for TPN and lipid emulsion with the piggyback method. Immediately after the completion of lipid emulsion infusion, we conducted flushing with saline solution. The volume of saline solution was none, 5, 10, or 20 mL at a flow rate of 1 mL/s. Infusion solution that was stagnant in the infusion device was collected immediately before completing the lipid emulsion infusion and 20 h after flushing, i.e., 24 h after starting the infusion for TPN, and the number of viable bacteria was determined. Results: The number of viable E. coli increased in the infusion device of all three species used in this experiment 24 h after starting the lipid emulsion infusion without flushing. We found that bacterial growth could be prevented through flushing with saline solution after the completion of lipid emulsion infusion and flushing out the stagnant infusion solution in the closed-type infusion device. Conclusions: We found that if E. coli was present in the closed-type infusion device, it would multiply. We also found that the number of viable bacteria varied according to the variety and internal structure of the closed-type infusion device as well as the liquid volume used for flushing, although flushing can prevent the growth of microorganisms. Proper management and manipulation of infusion is required to prevent infection.
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Contaminación de Equipos/prevención & control , Escherichia coli/aislamiento & purificación , Emulsiones Grasas Intravenosas/administración & dosificación , Infusiones Intravenosas/instrumentación , Nutrición Parenteral Total/instrumentación , Escherichia coli/crecimiento & desarrollo , Nutrición Parenteral Total/métodosRESUMEN
Artificial pancreas system (APS) is an emerging new treatment for type 1 diabetes mellitus. The aim of this study was to develop a rat APS as a research tool and demonstrate its application. We established a rat APS using Medtronic Minimed Pump 722, Medtronic Enlite sensor, and the open artificial pancreas system as a controller. We tested different dilutions of Humalog (100 units/ml) in saline ranged from 1:3 to 1:20 and determined that 1:7 dilution works well for rats with ~500g bodyweight. Blood glucose levels (BGL) of diabetic rats fed with chow diet (58% carbohydrate) whose BGL was managed by the closed-loop APS for the total duration of 207h were in euglycemic range (70-180 mg/dl) for 94.5% of the time with 2.1% and 3.4% for hyperglycemia (>180mg/dl) and hypoglycemia (<70 mg/dl), respectively. Diabetic rats fed with Sucrose pellets (94.8% carbohydrate) for the experimental duration of 175h were in euglycemic range for 61% of the time with 35% and 4% for hyperglycemia and hypoglycemia, respectively. Heathy rats fed with chow diet showed almost a straight line of BGL ~ 95 mg/dl (average 94.8 mg/dl) during the entire experimental period (281h), which was minimally altered by food intake. In the healthy rats, feeding sucrose pellets caused greater range of BGL in high and low levels but still within euglycemic range (99.9%). Next, to study how healthy and diabetic rats handle supra-physiological concentrations of glucose, we intraperitoneally injected various amounts of 50% dextrose (2, 3, 4g/kg) and monitored BGL. Duration of hyperglycemia after injection of 50% dextrose at all three different concentrations was significantly greater for healthy rats than diabetic rats, suggesting that insulin infusion by APS was superior in reducing BGL as compared to natural insulin released from pancreatic ß-cells. Ex vivo studies showed that islets isolated from diabetic rats were almost completely devoid of pancreatic ß-cells but with intact α-cells as expected. Lipid droplet deposition in the liver of diabetic rats was significantly lower with higher levels of triacylglyceride in the blood as compared to those of healthy rats, suggesting lipid metabolism was altered in diabetic rats. However, glycogen storage in the liver determined by Periodic acid-Schiff staining was not altered in diabetic rats as compared to healthy rats. A rat APS may be used as a powerful tool not only to study alterations of glucose and insulin homeostasis in real-time caused by diet, exercise, hormones, or antidiabetic agents, but also to test mathematical and engineering models of blood glucose prediction or new algorithms for closed-loop APS.
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Glucemia/análisis , Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 1/terapia , Insulina/administración & dosificación , Páncreas Artificial , Animales , Glucemia/efectos de los fármacos , Diabetes Mellitus Experimental/sangre , Diabetes Mellitus Experimental/inducido químicamente , Diabetes Mellitus Experimental/diagnóstico , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/inducido químicamente , Diabetes Mellitus Tipo 1/diagnóstico , Hemoglobina Glucada/análisis , Humanos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/métodos , Masculino , Ratas , Estreptozocina/administración & dosificación , Estreptozocina/toxicidadRESUMEN
BACKGROUND: Rapid infusion of warmed blood products is the cornerstone of trauma resuscitation and treatment of surgical and obstetric massive hemorrhage. Integral to optimizing this delivery is selection of an intravenous (IV) catheter and use of a rapid infusion device (RID). We investigated which IV catheter and RID system enabled the greatest infusion rate of blood products and the governing catheter characteristics. STUDY DESIGN AND METHODS: The maximum flow rates of nine IV catheters were measured while infusing a mixture of packed red blood cells and fresh frozen plasma at a 1:1 ratio using a RID with and without a patient line extension. To account for IV catheters that achieved the RID's maximum 1000 ml/min, the conductance of each infusion circuit configuration was calculated. RESULTS: IV catheters of 7-Fr caliber or higher reached the maximum pressurized flow rate. The 9-Fr multi-lumen access catheter (MAC) achieved the greatest conductance, over sevenfold greater than the 18 g peripheral catheter (4.6 vs. 0.6 ml/min/mmHg, p < .001). Conductance was positively correlated with internal radius (ß = 1.098, 95% CI 4.286-5.025, p < .001) and negatively correlated with length (ß= - 0.495, 95% CI -0.007 to 0.005, p < .001). Use of an extension line (ß= - 0.094, 95% CI -0.505 to -0.095, p = .005) was independently associated with reduced conductance in large caliber catheters. CONCLUSION: Short, large-diameter catheters provided the greatest infusion rates of massive transfusion blood products for the least pressure. For patients requiring the highest transfusion flow rates, extension tubing should be avoided when possible.
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Transfusión Sanguínea/instrumentación , Cateterismo/instrumentación , Catéteres , Diseño de Equipo , Transfusión de Eritrocitos/instrumentación , Humanos , Infusiones Intravenosas/instrumentaciónRESUMEN
PURPOSE: Drug protocols in intensive care units may require the concomitant administration of many drugs as patients' venous accesses are often limited. A major challenge for clinicians is to limit the risk of simultaneously infusing incompatible drugs. Incompatibilities can lead to the formation of particles and inactivation of drugs, whose consequences on the body have already been indicated. Our objective was to assess current strategies to counter the risk of incompatible infusions and control the resulting clinical consequences. METHODS: This review was independently conducted by three investigators in respect of the PRISMA statement. Three online databases were consulted. Full-text articles, notes, or letters written in English or French, published or in press between the 1990s and the end of February 2020, with clinical study design, were eligible. Parameters of interest were mainly number and size of particles, and a number of observed/avoided incompatibilities. RESULTS: All in all, 382 articles were screened, 17 meeting all the acceptance criteria. The strategies outlined and assessed were filtration, the use of multi-lumen devices, the purging of infusion lines, incompatibility tables and databases, and the use of standard operating procedures. CONCLUSION: Although many strategies have been developed in recent years to address drug incompatibility risks, clinical data is still lacking. All studies with in vitro design were excluded although some current innovative strategies, like niosomes, should be considered and studied by means of clinical data in the future.
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Incompatibilidad de Medicamentos , Infusiones Intravenosas/métodos , Unidades de Cuidados Intensivos , Protocolos Clínicos , Filtración , Humanos , Infusiones Intravenosas/instrumentaciónRESUMEN
PURPOSE: Despite the decreasing of environmental contamination throughout the anticancer drug circuit, the administration of chemotherapies remains at risk of occupational exposure for nurses. Many medical devices aim at securing administration, but none have been scientifically evaluated to verify the actual improvement. METHODS: A monocentric comparative before/after study was carried out in an oncology day hospital to evaluate the efficacy of Safe Infusion Devices in reducing drug exposure compared to usual infusion practices. The rate of nurses' gloves contamination was estimated. To avoid false negatives and to ensure sampling reproducibility, each sample of gloves was contaminated with a drop of topotecan. Association between contamination and other variables was investigated using a multivariate logistic regression analysis. RESULTS: The usual practice led to a rate of 58.3% of contaminated samples while Safe Infusion Devices to a rate of 15%: Safe Infusion Devices reduced the risk of gloves contamination by 85% in multivariate analysis (Odds ratio = 0.15; 95% confidence interval = 0.05-0.46; p < 0.001). Topotecan was identified in 100% of the samples. Only one case of cross-contamination has occurred. CONCLUSION: Despite the current practice of using neutral solvent-purged infusers, the occupational exposure remains high for nurses and Safe Infusion Devices significantly reduced this risk of exposure. However, glove contamination is only a surrogate endpoint. The results confirmed that the disconnection of empty bags resulted in occupational exposure. Except a contamination due to the leakage of a bag, no cross-contamination was detected. Safe Infusion Devices were highly effective but did not completely eliminate exposure.
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Antineoplásicos/análisis , Infusiones Intravenosas/instrumentación , Enfermeras y Enfermeros , Exposición Profesional/prevención & control , Ciclofosfamida/análisis , Guantes Protectores , Humanos , Irinotecán/análisis , Pemetrexed/análisis , Topotecan/análisisRESUMEN
The objective of this study was to describe hypersensitivity reactions with and without the use of in-line filters during intravenous etoposide therapy in pediatric oncology patients. This was a retrospective review of all patients treated in the Division of Oncology/Hematology/Bone Marrow Transplant at British Columbia Children's Hospital with intravenous etoposide between December 1, 2013 and February 1, 2018. Hypersensitivity reactions and anaphylaxis associated with etoposide infusions were compared over time, including 12 months prior to, 27 months during the use of, and for 12 months after the discontinuation of in-line filtration. There were 192 patients (median age 6.0 (IQR 2.8-13.0) years treated with etoposide and 486 etoposide infusions including 137 (28%) before, 261 (54%) during and 88 (18%) after use of in-line filters at our center. Twenty-six of 486 (5%) and 13/486 (3%) of infusions resulted in a type I hypersensitivity reaction and anaphylaxis, respectively. There were 2/137 (1%), 36/261 (14%) and 1/88 (1%) infusion reactions prior to, during and after in-line filter use, respectively. Infusion reactions during the in-line filter period were higher than during the pre-filter (Z = 3.978; p < 0.001) and post-filter (Z = 3.335; p < 0.001) periods of the study. These data suggest that the use of in-line filtration may be associated with increased frequency of hypersensitivity reactions to etoposide in pediatric cancer patients.
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Anafilaxia/inducido químicamente , Antineoplásicos Fitogénicos/efectos adversos , Etopósido/efectos adversos , Hipersensibilidad Inmediata/inducido químicamente , Inhibidores de Topoisomerasa II/efectos adversos , Antineoplásicos Fitogénicos/administración & dosificación , Niño , Preescolar , Etopósido/administración & dosificación , Femenino , Filtración/instrumentación , Humanos , Infusiones Intravenosas/instrumentación , Masculino , Estudios Retrospectivos , Inhibidores de Topoisomerasa II/administración & dosificaciónRESUMEN
Hepatorenal syndrome (HRS) is a fatal complication of renal dysfunction associated with ascites, liver failure and advanced cirrhosis. Although the best option for long-term survival is liver transplantation, in the critical acute phase, vasoconstrictors are considered first-line supportive agents. Terlipressin is the most widely used vasoconstrictor globally but owing to its short elimination half-life, it is usually administered six hourly by slow intravenous bolus injection. This requires patients to remain in hospital, increasing hospital bed costs and affecting their quality of life. An alternative option for administration of terlipressin is as a continuous infusion using an elastomeric infusor device in the patient's home. However, stability data on terlipressin in elastomeric infusor devices is lacking. This research aimed to evaluate the stability of terlipressin reconstituted in infusor devices for up to 7 days at 2-8 °C and subsequently at 22.5 °C for 24 h, to mimic home storage and administration temperatures. We report that terlipressin was physically and chemically stable under these conditions; all reconstituted infusor concentrations retained above 90% of the original concentration over the test conditions. No colour change or precipitation in the solutions were evident.
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Síndrome Hepatorrenal/tratamiento farmacológico , Bombas de Infusión/normas , Terlipresina/administración & dosificación , Vasoconstrictores/administración & dosificación , Estabilidad de Medicamentos , Humanos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/métodos , Terlipresina/química , Terlipresina/uso terapéutico , Vasoconstrictores/química , Vasoconstrictores/uso terapéuticoRESUMEN
Despite the common approach of bolus drug dosing using a patient's mass, a more tailored approach would be to use empirically derived pharmacokinetic models. Previously, this could only be possible though the use of computer simulation using programs which are rarely available in clinical practice. Through mathematical manipulations and approximations, a simplified set of equations is demonstrated that can identify a bolus dose required to achieve a specified target effect site concentration. The proposed solution is compared against simulations of a wide variety of pharmacokinetic models. This set of equations provides a near-identical solution to the simulation approach. A boundary condition is established to ensure the derived equations have an acceptable error. This approach may allow for more precise administration of medications with the use of point of care technology and potentially allows for pharmacokinetic dosing in artificial intelligence problems.
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Inteligencia Artificial , Cálculo de Dosificación de Drogas , Quimioterapia Asistida por Computador/métodos , Modelos Biológicos , Peso Corporal , Simulación por Computador , Relación Dosis-Respuesta a Droga , Humanos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/métodos , Sistemas de Atención de PuntoRESUMEN
Over 4000 preventable injuries due to medication errors occur each year in any given hospital. Smart pumps have been widely introduced as one means to prevent these errors. Although smart pumps have been implemented to prevent errors, they fail to prevent specific types of errors in the medication administration process and may introduce new errors themselves. As a result, unique prevention strategies have been implemented by providers. No catalog of smart pump error types and prevention strategies currently exists. The aim of this study is to review and catalog the types of human-based errors related to smart pump use identified in the literature and to summarize the associated error-prevention strategies. We searched MEDLINE, PubMed, PubMed Central, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for literature pertaining to human-based errors associated with smart pumps. Studies related to smart pump implementation, other types of pumps, and mechanical failures were excluded. Final selections were mapped for error types and associated prevention strategies. A total of 1177 articles were initially identified, and 105 articles were included in the final review. Extraction of error types and prevention strategies resulted in the identification of 18 error types and ten prevention strategies. Through a comprehensive literature review, we compiled a catalog of smart pump-related errors and associated prevention strategies. Strategies were mapped to error types to provide an initial framework for others to use as a resource in their error reviews and improvement work. Future research should assess the application of the resources provided by this review.
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Quimioterapia Asistida por Computador , Seguridad de Equipos , Bombas de Infusión , Infusiones Intravenosas/instrumentación , Errores de Medicación/prevención & control , Diseño de Equipo , HumanosRESUMEN
Robotic intravenous poles are automated supportive instrument that needs to be triggered by patients to hold medications and needed supplies. Healthcare engineering of robotic intravenous poles is advancing in order to improve the quality of health services to patients worldwide. Existing intravenous poles in the market were supportive to patients, yet they constrained their movement, consumed the time of both the patient and the nurse, and they were expensive in regard to what they offer. Although robotic poles overcame some of the movement limitations of the commercial/market poles, they were partially automated and did not offer additional technological features. The aim of our work was to develop a fully automated Biomedical Intravenous Pole Robot (BMIVPOT) to resolve the aforementioned limitations and to offer new technological features to intravenous poles, thereby promoting the health services. Several sensors and build-up materials were empirically chosen to be cost-effective and fulfill our needs. The new prototype was divided into three steps: simulated prototype, real implementation of the prototype, and testing and evaluation. Simulation results showed the best qualitative way to fit all the specifications in the robotic system, such as the shape, sensors, and connections in order to provide the proper functionality of the system. Experimental and real results provided the manufactured parts, implemented sensors, and the final robot. Testing the tracking and the flow sensor performances were provided. Evaluation of our Biomedical Intravenous Pole Robot with alternatives showed that our robot outperforms the other poles in many aspects including the features it offers, the percentage of interventions it comprised, the reliability, and cost-effectiveness. The overall percentage of features offered by our Biomedical Intravenous Pole Robot was 60% higher than that offered by peer research poles and 80% higher than that of the market poles. In addition, the average percentage of integration of interventions (architecture, sensor, wireless, tracking, and mechanical) in the Biomedical Intravenous Pole Robot was at least 56% higher than that of the alternative poles. According to the results, Biomedical Intravenous Pole Robot offers a cost-effective price as compared to the others. As a future prospect, we intend to add more features to this prototype in order to enhance it, such as vital signs detection, and improve the tracking system.
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Infusiones Intravenosas/instrumentación , Robótica , Terapia Asistida por Computador/instrumentación , Inteligencia Artificial , Automatización , Simulación por Computador , Diseño Asistido por Computadora , Análisis Costo-Beneficio , Diseño de Equipo , Equipos y Suministros de Hospitales , Humanos , Procesamiento de Imagen Asistido por Computador , Microcomputadores , Aplicaciones Móviles , Seguridad del Paciente , Reproducibilidad de los Resultados , Integración de Sistemas , Interfaz Usuario-ComputadorRESUMEN
There has been a surging interest in using elastomeric infusion devices to deliver outpatient parenteral antimicrobial therapy (OPAT), which is more cost-effective than standard antibiotic administration, which requires multiple daily home visits. This has been particularly important since the outbreak of the coronavirus pandemic, because reducing patient contact can also help to minimise transmission of COVID-19 to outpatients who are at a high risk of COVID-19-triggered complications. In this retrospective study, the clinical effectiveness of intravenous (IV) infusion of flucloxacillin using an elastomeric device was explored in a convenience sample of patients. Patients with three primary infective diagnoses-bloodstream infection, non-vertebral osteomyelitis and vertebral osteomyelitis-were included in the analyses. In non-vertebral osteomyelitis patients, Accufuser antibiotic infusion shortened the course of OPAT care relative to standard antibiotic administration (p<.05). In contrast, in vertebral osteomyelitis patients, it prolonged the course of OPAT care relative to standard administration (p<.05). In patients with bloodstream infections, no significant difference was found between the treatment modes (p=.93). Thus, the clinical effectiveness of Accufuser antibiotic infusion varies among patients with different infective diagnoses, and there seems to be a complex relationship between the method of antibiotic delivery and the patient's condition.
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Antibacterianos/administración & dosificación , Bacteriemia/tratamiento farmacológico , Enfermería en Salud Comunitaria/métodos , Floxacilina/administración & dosificación , Terapia de Infusión a Domicilio/métodos , Bombas de Infusión , Osteomielitis/tratamiento farmacológico , Enfermedades de la Columna Vertebral/tratamiento farmacológico , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/prevención & control , Atención a la Salud/métodos , Elastómeros , Humanos , Infusiones Intravenosas/instrumentación , Pandemias/prevención & control , Neumonía Viral/prevención & control , Estudios Retrospectivos , SARS-CoV-2RESUMEN
Background and Objectives: An effective flushing technique is essential to reduce intravenous (IV)-related complications and improve patient care. New technology should contribute to such improvements, while reducing costs and increasing care efficiency. This study evaluated the efficacy, safety, and convenience of a new flushing technique using a Baro Flush™ controller. Materials and Methods: We evaluated the efficacy and safety of Baro Flush™ by measuring the infusion flushing volume and pressure in vitro. Afterwards, we prospectively enrolled 3000 patients with flushing and assigned 1500 patients with a new technique for flushing and 1500 with a conventional flushing method, which was performed by 48 registered nurses (RNs) at the Gil Medical Center in June 2018. The efficacy, safety, and convenience of the new flushing method were evaluated though a questionnaire survey. Results: The average flushing pressure was 12.5 ± 0.6 psi (86.18 ± 4.14 kPa) with 1.2 ± 0.2 mL per flush, as recommended by the Centers for Disease Control and Prevention based on 85 experiments. No IV-catheter-related complications were reported by the RNs during the study. More than 80% of the RNs reported that the new flushing method was easier to learn, improved care efficacy, and was more convenient than conventional flushing. Conclusions: The new flushing method using a Baro Flush™ controller showed improved efficacy, safety, and convenience compared with the conventional flushing method, and no IV-catheter-related complications occurred, including occlusion and inflammation. The new flushing method promises to reduce IV-catheter-related complications and shows improved efficacy, safety, and convenience.
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Cateterismo Periférico/instrumentación , Diseño de Equipo/normas , Infusiones Intravenosas/instrumentación , Irrigación Terapéutica/normas , Adulto , Cateterismo Periférico/métodos , Diseño de Equipo/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Irrigación Terapéutica/instrumentación , Irrigación Terapéutica/métodosRESUMEN
OBJECTIVE: To develop a new type infusion set and apply it to the clinic, as well as explore its effectiveness in the prevention from needle stick injuries. METHODS: A total of 200 inpatients who were in need of intravenous infusion with a disposable infusion needle were included and randomly divided into two groups: intervention group and control group. Disposable infusion needles with a separation-free safety tube were used in the intervention group, whereas conventional ones were used in the control group. Then, effects of the two types of infusion sets were observed and compared. RESULTS: As for the operation time for infusion, it was (82.19 ± 1.80) seconds in the intervention group and (83.02 ± 1.83) seconds in the control group, with the difference statistically significant (P < 0.05). Besides, the exposure time of the needles after infusion in the intervention group was (3.36 ± 0.17) seconds while (18.85 ± 1.18) seconds in the control group; the difference between which was statistically significant (P < 0.05). In terms of the time for needle disposal, (18.60 ± 0.84) seconds was required in the intervention group, while for the control group, it took (18.85 ± 1.18) seconds, and the difference between two groups was of statistical significance as well (P < 0.05). Nevertheless, there was no statistically significant difference in the accidental slip rate of the needles as that turned out 0% in both groups (P > 0.05). It was worth noting that the block rate of the disposed needles in the intervention group was 100%. CONCLUSION: The separation-free safety tube on the disposable infusion needle could instantly block the sharp needle after infusion, which reduces the needle exposure time and lowers the risk of needle stick injuries. In the meantime, the safety tube is convenient to use, and its application can shorten the time for infusion and needle disposal, consequently improving the working efficiency of nurses. As the new type safety tube has above advantages and would not raise the risk of needle slippage, it is worthy of clinical promotion.
Asunto(s)
Equipos Desechables , Infusiones Intravenosas/instrumentación , Agujas , Lesiones por Pinchazo de Aguja/prevención & control , China , Biología Computacional , Diseño de Equipo , Humanos , Infusiones Intravenosas/efectos adversos , Infusiones Intravenosas/enfermería , Agujas/efectos adversos , Lesiones por Pinchazo de Aguja/enfermería , Personal de Enfermería , Traumatismos Ocupacionales/enfermería , Traumatismos Ocupacionales/prevención & control , Seguridad , Factores de TiempoRESUMEN
BACKGROUND: In hospitals, some problems still exist, such as transfusion reaction that cannot be dealt with in time, medical staff cannot observe the physiological information of the infusion patients in real time, and the infusion speed cannot be controlled smartly. OBJECTIVE: To address these problems, we propose a method for intelligent monitoring and designed a controller for dripping speed regulation. METHODS: A photoelectric sensor was used to obtain the heart rate (HR) information, and a PID parameter self-tuning controller based on the fuzzy control principle was developed to establish a multi-stage adaptive control method based on HR feedback. By controlling the rotation of the motor to drive the cam to control the drip rate smartly. Also, the infusion and physiological information are transmitted to the nurse station to monitor the possible transfusion reaction. RESULTS: The experiments show that the intelligent infusion controller can achieve HR signal detection with an average accuracy of over 94%, dripping speed detection and adjustment with an average accuracy of above 98% and adjustment time within 35 seconds. CONCLUSION: Our study proved that the intelligent infusion controller can control the infusion process intelligently and effectively, and has excellent reliability, small steady-state error and high practical value.