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1.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 38(9): 425-430, nov. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-198626

RESUMO

INTRODUCTION: Data concerning the use of peripherally inserted central catheters (PICC) for the administration of intravenous (IV) antimicrobials in the acute care setting is scarce. METHODS: We performed a single-center retrospective case-control study (1:1). Case subjects were defined as patients who received IV antimicrobial treatment through a PICC line placed and maintained by specifically trained nurses (PICC group). Control subjects were defined as patients who received antimicrobial therapy by a peripheral or a central venous catheter (CVC) (control group). Control subjects were matched by type of antimicrobial, causative microorganism of the infection that was being treated and duration of treatment. An event leading to undesired catheter removal (ELUCR) was defined as any circumstance which lead to the removal of the indwelling catheter other than the completion of the scheduled course of antimicrobial therapy. RESULTS: The study included 50 patients in each group. The total follow-up time was 1376 catheter-days for the PICC group and 1362 catheter-days for the control group. We observed a significantly lower incidence of ELUCR in the PICC group (0.2 versus 7.7 events per 100 catheter-days; P < 0.001). When the incidence of ELUCR was analyzed according to the duration of indwelling catheterisation for each type of catheter (divided into one-week intervals), differences between both groups were also significant (P-values ≤ 0.001 for the first three weeks of treatment). During the second week of IV treatment, only one patient in the PICC group (2.1%) developed an ELUCR compared to 19 (38.8%) in the control group (P < 0.001). CONCLUSIONS: A PICC placed and maintained by a dedicated nursing team is an excellent alternative to peripheral venous catheters or CVCs for administrating antimicrobial therapy for both short and long periods of treatment


INTRODUCCIÓN: Existe escasa información disponible sobre el empleo de catéteres venosos centrales de inserción periférica (PICC en sus siglas en inglés) para la administración de antimicrobianos por vía intravenosa (IV) en la atención a pacientes con procesos agudos. MÉTODOS: Realizamos un estudio unicéntrico retrospectivo de casos y controles (1:1). Los casos estaban constituidos por pacientes que recibieron tratamiento antimicrobiano IV a través de un catéter tipo PICC que fue insertado y cuidado por un equipo de enfermería especialmente entrenado a tal efecto (grupo PICC). Los controles estaban constituidos por pacientes que recibieron el tratamiento antimicrobiano a través de un catéter venoso periférico o a través de un catéter venoso central (CVC) (grupo control). Los controles fueron emparejados con los casos considerando el tipo de antimicrobiano administrado, el microorganismo causal de la infección que se estaba tratando y la duración del tratamiento. Se definió como un evento que condujo a la retirada no deseada del catéter (ECRDC) a cualquier circunstancia que obligara a la retirada del catéter insertado antes del tiempo programado para completar el tratamiento antimicrobiano establecido. RESULTADOS: El estudio incluyó 50 pacientes en cada grupo. El tiempo total de seguimiento fue de 1.376 días de catéter en el grupo PICC y de 1.362 días de catéter en el grupo control. Se observó una incidencia de ECRDC significativamente menor en el grupo PICC que en el grupo control (0,2 versus 7,7 eventos por cada 100 días de catéter; P < 0,001). Cuando la incidencia de ECRDC se analizó según la duración del tiempo de inserción de cada tipo de catéter (dividido en intervalos de una semana), se pudo constatar que las diferencias entre ambos grupos también eran significativas (P ≤ 0.001 para las tres primeras semanas de tratamiento). Durante la segunda semana de tratamiento IV, solamente un paciente en el grupo PICC (2,1%) desarrolló un ECRDC en comparación con 19 (38,8%) en el grupo control (P (P < 0,001). CONCLUSIONES: Un catéter tipo PICC insertado y cuidado por un equipo de enfermería entrenado es una excelente alternativa a los catéteres venosos periféricos o a los CVC para la administración de antimicrobianos tanto para periodos cortos como para periodos largos de tiempo


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cateterismo Periférico/enfermagem , Cateteres Venosos Centrais , Anti-Infecciosos/administração & dosagem , Equipe de Enfermagem , Estudos Retrospectivos , Remoção de Dispositivo/efeitos adversos , Cateterismo Periférico/efeitos adversos , Resultado do Tratamento , Fatores de Tempo , Fatores de Risco , Reprodutibilidade dos Testes , Cateteres de Demora/efeitos adversos
2.
PLoS One ; 15(9): e0238881, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941490

RESUMO

BACKGROUND: Adherence to the best standards of nursing practice is the fundamental principle to improve patient outcome and prevent nursing procedure related-infections. A peripheral venous catheter (PVC) is the most common invasive procedure performed in nursing care. Its poor performance could expose patients to bloodstream-related infections. The present study aimed to assess post-basic nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters. METHODS: A cross-sectional study design was conducted on May 01-03, 2019, using a convenient sample 239 among post-basic nursing students in Wollega University. RESULTS: The study result showed that nursing students' had a low mean (4.1±1.52) of knowledge about PVC procedure management. Only 41% of the respondents have adhered to recommendations of CDC guidelines. Among the provided options of the items, none achieved 100% correct answers. The majority of nursing students (77%) responded that antiseptic handwashing is always performed before insertion of PVCs. Meanwhile, few students (5%) correctly answered that the infusion set is recommended to be removed after 96 hours when neither lipids nor blood products are administered. In multivariable regression analysis, nursing students who had received training (AOR = 2.9, 95% CI (1.6, 5.1)) and who were younger (AOR = 2.4, 95% CI (1.3, 4.3)) significantly associated with a higher score of knowledge. CONCLUSIONS: This study finding shows that an overall level of knowledge of post-basic nursing students is inadequate. Measurements such as an increase in the provision of adequate training by nurses educators based on evidence-based guidelines could improve the post-basic nursing students' knowledge.


Assuntos
Cateterismo Periférico/enfermagem , Competência Clínica/normas , Adulto , Cateterismo Periférico/normas , Estudos Transversais , Educação de Pós-Graduação em Enfermagem , Enfermagem Baseada em Evidências , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Guias de Prática Clínica como Assunto , Estudantes de Enfermagem , Adulto Jovem
3.
J. nurs. health ; 10(3): 20103003, jul.2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1129505

RESUMO

Objetivo: descrever características sociodemográficas e clínicas relacionadas ao uso dos cateteres venosos periféricos em pacientes de uma unidade clínica hospitalar. Método: descritivo, quantitativo, realizado em um Hospital Universitário do Estado do Rio de Janeiro, com 50 pacientes em uso de dispositivo intravenoso periférico, de maio a julho de 2018 e de julho a setembro de 2019. Utilizou-se um formulário sobre o perfil dos pacientes e o processo de cateterização venoso. A análise foi por estatística descritiva. Resultados: predomínio de idosas, com diagnóstico relacionado ao sistema imunológico. Ocorreram 148 punções, com média de 2,7 por paciente. O tempo de permanência variou de menos de 24 horas a sete dias. A remoção dos cateteres foi eletiva seguida de complicações, como obstrução e flebite. Conclusão: o cuidado de enfermagem relacionado à terapia intravenosa é um desafio na instituição, revelando a necessidade de investimentos em educação continuada e permanente.(AU)


Objective: to describe sociodemographic and clinical characteristics related to the use of peripheral venous catheters in patients in a hospital clinic ward. Method: descriptive, quantitative, carried out in a University Hospital in the State of Rio de Janeiro, with 50 inpatients using a peripheral intravenous device, from May to July 2018 and from July to September 2019. A form was used on the profile of the patients and the process of venous catheterization. The analysis was by descriptive statistics. Results: predominance of elderly patients with a diagnosis related to the immune system. There were 148 punctures, with an average of 2.7 per patient. Catheter residence time ranged from less than 24 hours to seven days. Withdrawal was elective form followed by complications, such as obstruction and phlebitis. Conclusion: nursing care related to intravenous therapy is a challenge in the institution, revealing the need for investments in continuing and permanent education.(AU)


Objetivo: describir características sociodemográficas y clínicas relacionadas con el uso de catéteres venosos periféricos en pacientes en hospital. Método: descriptivo, cuantitativo, realizado en Hospital Universitario del Estado de Río de Janeiro, con 50 pacientes hospitalizados que utilizan dispositivo intravenoso periférico, de mayo a julio de 2018 y de julio a septiembre de 2019. Se utilizó formulario sobre perfil de los pacientes y cateterismo venoso. El análisis fue por estadística descriptiva. Resultados: predominio de pacientes de edad avanzada con diagnóstico relacionado con el sistema inmune. Hubo 148 punciones, con un promedio de 2.7 por paciente. El tiempo de residencia del catéter varió de menos de 24 horas a siete días. La retirada fue electiva seguida de complicaciones, como obstrucción y flebitis. Conclusión: el cuidado de enfermería relacionado con la terapia intravenosa es un desafío en la institución, lo que revela la necesidad de inversiones en educación continua y permanente.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Cateterismo Periférico/enfermagem , Hospitalização , Fatores de Tempo , Cateterismo Periférico/efeitos adversos , Cuidados de Enfermagem
4.
Br J Nurs ; 29(8): S20-S27, 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32324453

RESUMO

Vascular access device insertion is a common procedure in healthcare, and complications associated with vascular access can be serious and cause considerable patient harm. The use of care bundles to reduce the risks of these complications is well documented. However, the removal of devices, especially those associated with medical adhesive, can cause significant skin injuries, which often could be avoided if this aspect is included in the care bundle and the risk factors are better understood in healthcare. Appeel Sterile is an effective sterile silicone-based medical adhesive remover that is available in a variety of formats. It is the only sterile medical adhesive remover available, which makes it the safest choice for use with vascular access devices.


Assuntos
Cateterismo Periférico/enfermagem , Silicones/uso terapêutico , Higiene da Pele/enfermagem , Ferimentos e Lesões/prevenção & controle , Humanos , Risco , Pele/lesões , Higiene da Pele/métodos , Adesivos Teciduais/efeitos adversos , Ferimentos e Lesões/etiologia
5.
Br J Nurs ; 29(8): S12-S19, 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32324463

RESUMO

Caring for patients with peripheral intravenous cannulas/catheters (PIVCs) is an important part of the nurse's role and insertion of PIVCs has traditionally been a post-registration nursing skill. With the introduction of the Nursing and Midwifery Council Standards of Proficiency for Registered Nurses in 2018, insertion of PIVCs is to be incorporated in pre-registration nursing programmes for all four fields of nursing practice. Although IV cannulation is a commonly performed clinical procedure, it is associated with significant risks and complications, which can cause pain for patients. This article outlines the factors that can cause pain for adult patients requiring a PIVC and recommends that the use of local anaesthetics be more widely considered when inserting a cannula. The identification, prevention and clinical management of commonly occurring painful local complications that can arise post-PIVC insertion are also discussed.


Assuntos
Cateterismo Periférico/enfermagem , Dor/prevenção & controle , Adulto , Cateterismo Periférico/efeitos adversos , Humanos , Dor/etiologia
6.
Nursing ; 50(5): 66-69, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32332510

RESUMO

PURPOSE: To understand nursing perceptions of hospital requirements for routine resiting of short peripheral catheters (SPCs). METHODS: This exploratory research project at the authors' medium-sized regional referral and trauma center utilized an online survey to assess the perceived efficacy and patient disruption related to SPC resiting among acute care nurses. RESULTS: Out of 203 eligible nurses, 81 participated. The survey results support the perception that SPC insertions and resiting can be time-consuming and disruptive to the flow of care. The strongest correlation occurred between patients who had requested no SPC resiting and the reported disruption from SPC resiting. CONCLUSION: Based on the survey results, a formal recommendation was made within the hospital system to amend the existing policy and remove the requirement for SPC resiting after 96 hours in favor of the nurses' best clinical judgment.


Assuntos
Atitude do Pessoal de Saúde , Cateterismo Periférico/enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Padrões de Prática em Enfermagem/estatística & dados numéricos , Adulto , Pesquisas sobre Serviços de Saúde , Administração Hospitalar , Humanos , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Política Organizacional , Fluxo de Trabalho
8.
Eur J Pediatr ; 179(3): 439-446, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31788740

RESUMO

This pre-post intervention study was conducted in Neonatal Intensive Care Units in two Chinese hospitals. The objective was to evaluate the effectiveness and safety of intracavitary electrocardiogram (IC-ECG)-guided peripherally inserted central catheter (PICC) placement and tip positioning in premature infants. A total of 161 premature infants who required a PICC were enrolled and divided into two groups: pre-intervention group (n = 83) from October 2017 to July 2018 and post-intervention IC-ECG group (n = 78) from August 2018 to March 2019. Nurses were trained from May 2018 to July 2018. The reposition rate in the IC-ECG group and pre-interventions group was 3.85% and 19.28%, respectively (OR 5.970; 95% CI 1.666-21.395; p = 0.002). More infants achieved optimal tip position at the first attempt in the IC-ECG group than the pre-intervention group (93.59% vs 73.49%; OR 0.190; 95%CI 0.068-0.531; p = 0.001). The overall catheter-related complications in the pre-intervention group were 14.46% compared to 3.84% in the IC-ECG group (OR 2.962; 95%CI 1.013-8.661; p = 0.040). However, no significant differences were observed between the individual complication leakage, phlebitis and catheter-related blood stream infection.Conclusions: IC-ECG-guided peripherally inserted central catheter placement and tip positioning technology might decrease reposition rates, achieve more accurate tip positioning at the first attempt and might reduce catheter-related complications in premature infants. Further robust RCTs are needed to confirm the effectiveness of IC-ECG-guided PICC placement and tip positioning in neonates.What is Known:• Chest radiography is the gold standard for tip position confirmation of peripherally inserted central catheter placement.• Studies in adult patients have shown that electrocardiogram guidance in the placement of central venous catheters can be beneficial, while evidence in neonates is limited.What is New:• Intracavitary electrocardiogram-guided peripherally inserted central catheter placement might be superior to chest radiography in preterm infants.• Decreasing the repositioning rates and correct tip position of peripherally inserted central catheters might reduce catheter-related complications.


Assuntos
Cateterismo Venoso Central/métodos , Cateterismo Periférico/métodos , Eletrocardiografia/métodos , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/enfermagem , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/enfermagem , Cateteres Venosos Centrais , Estudos Controlados Antes e Depois , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Masculino
9.
J Nurs Care Qual ; 35(2): 108-114, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31290781

RESUMO

BACKGROUND: A community hospital policy of routinely replacing peripheral intravenous catheters (PIVCs) needed updating to the clinical practice guideline (CPG) of clinically indicated replacement. METHODS: Guided by Lean principles, a clinical nurse leader (CNL) led a quality improvement small test of change on a 38-bed medical unit. The impact of the CPG was evaluated using quality, safety, and workflow measures. RESULTS: Nurses managed 469 inpatients, receiving 1033 PIVCs. Routine PIVC replacement declined from 34% to 3% (P < .001). PIVC dwell time ranged from 4 to 20 days and did not increase phlebitis (P = .41) or catheter-related bloodstream infections. Nurses attributed the improvements in workflow (P = .01) and the quality of patient care (94%) to the updated PIVC guideline. CONCLUSIONS: Clinically-indicated PIVC replacement reduced unnecessary catheter insertions, maintained patient safety, improved efficiency, and is being implemented hospital-wide. This project highlights and advances the CNL role in transforming healthcare.


Assuntos
Cateterismo Periférico , Guias como Assunto/normas , Enfermeiras Clínicas , Melhoria de Qualidade/normas , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Periférico/enfermagem , Cateterismo Periférico/normas , Cateteres de Demora , Remoção de Dispositivo/enfermagem , Remoção de Dispositivo/normas , Hospitais Comunitários , Humanos , Segurança do Paciente
10.
J Vasc Nurs ; 37(4): 246-249, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31847978

RESUMO

Establishing reliable peripheral intravenous access is one of the most common procedures performed daily by nurses across clinical settings in the hospital. The insertion of peripheral intravenous access devices is usually guided by palpation, direct visualization, landmark technique, or by trial and error. The invasive nature of the procedure accompanied by the associated risks requires successful cannulation on the initial attempt. In an effort to decrease the number of peripheral venous access attempts in patients with difficult venous access, a course was developed to educate a cohort of registered nurses on the basic principles and use of ultrasound. After successful completion of the course, each registered nurse was required to perform a minimum of 10 proctored successful ultrasound venous peripheral intravenous catheter insertions. The first attempt success rate for the proctored ultrasound venous peripheral intravenous catheter attempts was 83%, which was higher than that reported in the literature (20%-50%). Overall, the program effectively demonstrated a decrease in the number of attempts required to insert a peripheral venous catheter in patients with difficult venous access.


Assuntos
Administração Intravenosa , Cateterismo Periférico/enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Ultrassonografia de Intervenção , Humanos
11.
Rev. enferm. UERJ ; 27: e42567, jan.-dez. 2019. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1046235

RESUMO

Objetivo: identificar os fatores que dificultam a punção venosa periférica em adultos. Método: revisão integrativa da literatura, sem recorte temporal. A busca dos artigos ocorreu no mês de janeiro de 2018 nas seguintes bases de dados: PubMed, LILACS, CINAHL, SciELO, Web of Science e Scopus, com inclusão de 12 artigos. Foram analisados quanto ao ano, país de publicação, fatores associados e nível de evidência. Resultados: foram encontradas publicações de 2003 a 2017. A prevalência da punção venosa periférica difícil variou entre 17% e 59,3%. Entre os fatores que dificultam a punção, os mais frequentes foram: demográficos (sexo, idade) , clínicos (comorbidades, estado nutricional, visibilidade e palpabilidade da rede venosa), do dispositivo (calibre e modelo) e a habilidade do profissional. Conclusão: a dificuldade para punção é variável de acordo com a complexidade assistencial. Fatores demográficos e clínicos, do dispositivo e a habilidade do profissional devem ser considerados.


Objective: to identify factors that pose difficulties in peripheral venipuncture in adults. Method: in this integrative literature review, with no time cutoff, search of the PubMed, LILACS, CINAHL, SciELO, Web of Science, and Scopus databases, in January 2018, yielded 12 articles for inclusion. These were examined for year, country of publication, associated factors, and level of evidence. Results: publications were found from 2003 to 2017. The prevalence of difficult peripheral venipuncture ranged from 17% to 59.3%. The most frequent factors making for difficult puncture were: demographic (gender, age), clinical (comorbidities, nutritional status, visibility and palpability of the venous network), device-related (caliber and model), and professional skill. Conclusion: difficulty in puncture varies with complexity of care. Demographic-, clinical-, device- and professional skill-related factors should be considered.


Objetivo: identificar los factores que dificultan la punción venosa periférica en adultos. Método: revisión integradora de la literatura, sin recorte temporal. Los artículos se buscaron en enero de 2018 en las siguientes bases de datos: PubMed, LILACS, CINAHL, SciELO, Web of Science y Scopus, con inclusión de 12 artículos. El análisis se hizo respecto al año, al país de publicación, a los factores asociados y al nivel de evidencia. Resultados: se encontraron publicaciones entre 2003 y 2017. La prevalencia de punción venosa periférica difícil osciló entre un 17% y un 59.3%. Entre los factores que dificultan la punción, los más frecuentes fueron: demográficos (género, edad), clínicos (comorbilidades, estado nutricional, visibilidad y cuán palpable es la red venosa), el dispositivo (calibre y modelo) y la habilidad del profesional. Conclusión: la dificultad en la punción varía según la complejidad de la atención. Deben considerarse factores demográficos y clínicos, del dispositivo y la habilidad del profesional.


Assuntos
Humanos , Masculino , Feminino , Cateterismo Periférico , Enfermagem , Adulto , Cateterismo Periférico/enfermagem , Cateterismo Periférico/métodos , Revisão
12.
Online braz. j. nurs. (Online) ; 18(4)dez. 2019. tab
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1123575

RESUMO

OBJETIVO: Analisar a influência do tempo de atuação de enfermeiros em unidade de terapia intensiva neonatal ou pediátrica no conhecimento sobre inserção e manuseio do cateter central de inserção periférica. MÉTODO: Estudo transversal, com 22 enfermeiros de terapia intensiva neonatal e pediátrica. Utilizou-se instrumento estruturado, produzido com base nas Diretrizes Práticas para Terapia Infusional. RESULTADOS: A mediana do tempo de formação foi de 9 anos e a do tempo de atuação em neonatologia ou pediatria foi de 8 anos. O tempo de atuação mostrou diferença significativa quanto ao conhecimento sobre "posicionamento do paciente para mensuração do comprimento do cateter" (p=0,010) e "Equipamentos de Proteção Individual preconizados para a troca de curativos" (p=0,004), sendo a maior proporção de acertos pelos enfermeiros com menor tempo de atuação. CONCLUSÃO: O tempo de atuação mostrou pouca influência no conhecimento dos profissionais. É relevante investir na educação continuada visando uma assistência mais segura.


OBJECTIVE: To analyze the influence of nurses' working time in a neonatal or pediatric intensive care unit on the knowledge about insertion and handling of the peripheral insertion central catheter. METHOD: A cross-sectional study conducted with 22 neonatal and pediatric intensive care nurses. A structured instrument was used, produced based on the Practice Guidelines for Infusional Therapy. RESULTS: The median of training time was 9 years and that of working time in neonatology or pediatrics was 8 years. The length of practice showed a significant difference regarding knowledge about "patient positioning for catheter length measurement" (p=0.010) and "Personal Protective Equipment recommended for dressing changes" (p=0.004), the largest proportion of correct answers being by nurses with shorter working time. CONCLUSION: Time of work showed little influence on the knowledge of the professionals. It is important to invest in continuing education for a safer care.


OBJETIVO: Analizar la influencia del tiempo de trabajo de las enfermeras en una unidad de cuidados intensivos neonatales o pediátricos en el conocimiento sobre la inserción y el manejo del catéter central de inserción periférica. MÉTODO: Estudio transversal realizado con 22 enfermeras de cuidados intensivos neonatales y pediátricos. Se utilizó un instrumento estructurado, elaborado en base a las Directrices prácticas para la Terapia de infusión. RESULTADOS: El tiempo medio de formación fue de 9 años y el de trabajo en neonatología o pediatría fue de 8 años. La duración de la práctica evidenció una diferencia significativa con respecto al conocimiento sobre "posicionamiento del paciente para medir la longitud del catéter" (p=0,010) y "Equipo de Protección Personal recomendado para los cambios de apósito" (p=0,004), con la mayor proporción de respuestas correctas en enfermeros con menor tiempo de trabajo. CONCLUSIÓN: El tiempo de trabajo evidenció escasa influencia en el conocimiento de los profesionales. Es importante invertir en educación continua para una atención más segura.


Assuntos
Humanos , Prática Profissional , Cateterismo Periférico/enfermagem , Unidades de Terapia Intensiva Pediátrica , Unidades de Terapia Intensiva Neonatal , Cateteres , Enfermeiras e Enfermeiros , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Punções , Estudos Transversais , Educação Continuada em Enfermagem , Cateteres/efeitos adversos
13.
Rev. enferm. UERJ ; 27: e44521, jan.-dez. 2019. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1053550

RESUMO

Objetivo: identificar as necessidades humanas básicas alteradas nos neonatos com cateter central de inserção periférica em Unidade de Terapia Intensiva Neonatal, à luz da Teoria das Necessidades Humanas Básicas. Método: estudo transversal de abordagem quantitativa, realizado com 108 recém-nascidos em uma maternidade do Nordeste brasileiro entre os meses de fevereiro e dezembro de 2017. O instrumento de coleta de dados utilizado foi um roteiro de anamnese e exame físico. Os resultados foram analisados por meio da Teoria de Wanda Horta. Resultados: foram identificadas dez necessidades alteradas, com destaque para as mais prevalentes: integridade cutâneo-mucosa, ambiente, nutrição, hidratação, oxigenação e atenção. Conclusão: a identificação das necessidades humanas básicas alteradas nos neonatos com cateter central de inserção periférica pode subsidiar a elaboração de um plano de cuidados baseado em evidências e direcionado para essa população.


Objective: to identify the changed basic human needs in neonates with peripherally inserted central catheter, in light of the Theory of Basic Human Needs. Method: cross-sectional study, conducted with 108 newborns in a maternity hospital in the Northeast of Brazil between February and December 2017. An anamnesis and physical examination script was used for data collection. The results were analyzed using the Wanda Horta Theory. Results: ten altered needs were identified, highlighting the most prevalent ones: mucosal skin integrity, environment, nutrition, hydration, oxygenation and attention. Conclusion: the identification of altered basic human needs in neonates with peripherally inserted central catheter may support the elaboration of a care plan based on scientific evidences and directed to this population..


Objetivo: identificar las necesidades humanas básicas alteradas en recién nacidos con catéteres centrales insertados periféricamente en una Unidad de Cuidados Intensivos Neonatales, a la luz de la Teoría de las Necesidades Humanas Básicas. Método: estudio de enfoque cuantitativo, transversal, realizado con 108 recién nacidos en una maternidad en el nordeste de Brasil entre febrero y diciembre de 2017. El instrumento de recolección de datos utilizado fue un guión de historia y examen físico. Los resultados se analizaron utilizando la teoría de Wanda Horta. Resultados: se identificaron diez necesidades alteradas, destacando las más frecuentes: integridad de la piel, medio ambiente, nutrición, hidratación, oxigenación y atención. Conclusión: la identificación de necesidades humanas básicas alteradas en neonatos con catéter central insertado periféricamente puede apoyar la elaboración de un plan de atención basado en evidencias científicas y dirigido a esta población.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Teoria de Enfermagem , Recém-Nascido , Cateterismo Venoso Central , Cateterismo Periférico/enfermagem , Unidades de Terapia Intensiva Neonatal , Processo de Enfermagem , Cateterismo Periférico , Estudos Transversais , Nutrição Parenteral , Cuidados de Enfermagem
14.
Int J Nurs Educ Scholarsh ; 16(1)2019 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-31734657

RESUMO

Background Peripheral vein cannulation is one of the most common invasive practical nursing skills performed by registered nurses. However, many registered nurses lack competence in this practical skill. Learning peripheral vein cannulation associated with successful placement and maintenance is not well understood. Framework Ryle's ways of knowing, "knowing that" and "knowing how", can be used during peripheral vein cannulation learning to guide development and competence in this practical skill. Aim The aim of the article was to provide an overview of Ryle's ways of knowing and to make recommendations for best practices for nurse teachers and nurses teaching students peripheral vein cannulation. Conclusion Ryle's ways of knowing can assist nursing students in their learning and development of peripheral vein cannulation.


Assuntos
Cateterismo Periférico/enfermagem , Competência Clínica , Educação em Enfermagem/métodos , Currículo , Docentes de Enfermagem , Humanos , Guias de Prática Clínica como Assunto
15.
AANA J ; 87(1): 11-18, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31587738

RESUMO

Patients wait an average of 23 hours for a peripherally inserted central catheter (PICC) in our hospital. Long waits lead to delays in discharge and medication administration. For quality improvement, development of a Certified Registered Nurse Anesthetist (CRNA) PICC line backup service was proposed. This project collected benchmarking data about the current PICC line service over 3 months. The Intravenous (IV) Nursing Unit and the Interventional Radiology Division teams insert an average of 8.1 PICC lines daily, but the demand for PICC lines is 12 insertions per day; thus, the current, combined PICC service meets 66% of its demand. The CRNAs insert IV catheters daily and are eligible to insert PICC lines. A PICC training pro-gram was developed to train a CRNA in a standardized curriculum with simulation using a partial-task trainer. Using an N-of-1 method, the CRNA inserted 10 PICCs over 3 weeks under the guidance of an IV team PICC nurse. The CRNA reached a level of competence in PICC insertion after 10 attempts, with a 70% success rate, in intervals equivalent to those of IV PICC RNs. A CRNA can be trained in a short timeframe as a resource to decrease waiting for patients needing PICC lines.


Assuntos
Cateterismo Periférico/economia , Capacitação em Serviço , Enfermeiras Anestesistas/educação , Listas de Espera , Cateterismo Periférico/enfermagem , Análise Custo-Benefício , Humanos , Pennsylvania , Melhoria de Qualidade
16.
Cancer Nurs ; 42(6): E49-E58, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31658097

RESUMO

BACKGROUND: Cancer patients are considered the most at risk of the consequences of catheter occlusion. Therefore, nursing interventions that can effectively reduce the occlusion of peripherally inserted central catheter (PICC) lines must be identified to ensure a smooth treatment. OBJECTIVE: This study aimed to evaluate nursing interventions to minimize PICC line occlusion and make recommended measures for preventing or decreasing occlusion and abnormal extubation. METHODS: Studies about PICC occlusion that were published up to January 2017 were searched and screened in PubMed, Web of Science, Science Direct (Elsevier), EMBASE, Cochrane Library, and Chinese databases CNKI and Wanfang. Two independent reviewers screened the literature in accordance with the inclusion and exclusion criteria, assessed the quality of the included studies, and extracted the data. Further meta-analysis was performed using RevMan 5.3. RESULTS: Thirteen trials were included. Meta-analysis revealed that education for nurses (relative risk, 0.31; 95% confidence interval, 0.19-0.51; P < .00001) was significantly associated with PICC occlusion, whereas PICC type (relative risk, 0.60; 95% confidence interval, 0.32-1.15; P = .12) was not significantly associated with PICC occlusion. The solution to washing pipes and the PICC insertion techniques were descriptively analyzed to reach statistical significance. CONCLUSION: This study determined the correlation of PICC occlusion with the nurses' knowledge and skills, PICC types, flushing liquid and methods, and insertion techniques. IMPLICATIONS FOR PRACTICE: The findings of this study can serve as a guide for clinical work and for developing targeted measures to reduce occlusion.


Assuntos
Obstrução do Cateter/etiologia , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/enfermagem , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/enfermagem , Neoplasias/terapia , Enfermagem Oncológica/normas , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto
17.
Enferm. nefrol ; 22(3): 323-328, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187890

RESUMO

Introducción: El recambio plasmático terapéutico es una técnica extracorpórea de depuración sanguínea. El recambio plasmático terapéutico mediante el método de centrifugación (plasmacentrifugación) requiere flujos de 50 ml/min lo que permite realizar el intercambio con accesos vasculares periféricos. El principal objetivo de este estudio fué el de analizar el uso y las complicaciones del acceso vascular periférico en las sesiones de plasmacentrifugación. Material y Método: Estudio observacional descriptivo longitudinal sobre el análisis de complicaciones del acceso vascular periférico de las sesiones de plasmacentrifugación realizadas entre enero de 2017 y marzo de 2018. Resultados: Inclusión de un total de 93 sesiones de plasmacentrifugación, estas sesiones fueron llevadas a cabo en 9 pacientes con una mediana de 7 (P25:6; P75:10,5) sesiones por paciente. El 66,66% (n=6) fueron mujeres. En el 89,24% (n=83) de las sesiones se usó la centrifugación y en el 10,75% (n=10) la fotoaféresis. La etiología de enfermedad para estos pacientes fue: renal en el 55,55% (n=5) de los casos, neurológica en el 33,33% (n=3) de los casos y dermatológica en el 11,11% (n=1). De las 93 sesiones totales hubo problemas relacionados con la canalización de un acceso vascular periférico en el 52,69% de las sesiones (n=49). Conclusiones: Debido a que en más de la mitad de las sesiones se presentaron complicaciones en el abordaje del acceso vascular periférico, se concluye que es necesario el estudio vascular ambulatorio del paciente antes de la primera sesión, pudiendo ser útil el uso de la punción ecoguiada


Introduction: Therapeutic plasma exchange is an extracorporeal blood purification technique. Centrifuge-based therapeutic plasma exchange (plasmacentrifugation) requires flows of 50 ml/min which allows the exchange with peripheral vascular accesses. The main objective of this study is to analyze the use and complications of peripheral vascular access in plasmacentrifugation sessions. Material and Method: Descriptive observational longitudinal study on the analysis of peripheral vascular access complications in plasmacentrifugtion sessions between January 2017 and March 2018. Results: A total of 93 plasmacentrifugation sessions were included. Sessions were carried out in 9 patients with a median of 7 (P25:6; P75:10.5) per patient. 66.66% (n=6) were women. Centrifugation was used in 89.24% (n=83) of the sessions and in 10.75% (n=10) photoaferesis. The etiologies of the disease for these patients were: renal in 55.55% (n=5) of cases, neurological in 33.33% (n=3) of cases and dermatological in 11.11% (n=1). There were problems related to the channeling of peripheral vascular access in 52.69% of the sessions (n= 49). Conclusions: Because in more than half of the sessions there were complications in the channeling of peripheral vascular access, it is concluded that ambulatory vascular study of the patient is necessary before the first session, the use of ultrasound guided puncture may be useful


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cateterismo Periférico/enfermagem , Transfusão Total/enfermagem , Centrifugação/enfermagem , Dispositivos de Acesso Vascular/estatística & dados numéricos , Estudos Longitudinais , Cateterismo Periférico/efeitos adversos
18.
J Clin Nurs ; 28(23-24): 4488-4495, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31410906

RESUMO

AIMS AND OBJECTIVES: To explore whether the risk of peripheral venous catheters failure remained constant throughout catheter use in adult patients. BACKGROUND: Peripheral venous catheters, widely used in adult patients, may have a critical threshold dwell time associated with increased risk of catheter failure. DESIGN: Prospective, observational study. We have complied with the STROBE checklist of items. METHODS: This study was conducted from July-October 2018 in Hunan, China. Data on patient factors, catheter factors and catheter failure events were collected. Poisson regression was used to assess the effect of catheter dwell time on catheter failure while adjusting for other variables. RESULTS: A total of 1,477 patients were included in the analysis. There were 854 cases (57.8%) of catheter failure. The median dwell time to catheter failure was 52 hr (interquartile range: 36-73 hr). The incidence rate of catheter failure significantly increased by 1.1%/h in the first 38 hr after catheter insertion. From 39-149 hr, the incidence rate significantly decreased, and at >149 hr, there was no significant change in the incidence rate. Meanwhile, factors such as vascular quality and infused drugs showed having an impact on catheter failure events. CONCLUSIONS: The risk of catheter failure may not remain constant throughout the dwell time. The results suggest that nurses should assess the insertion site frequently in the first 38 hr. RELEVANCE TO CLINICAL PRACTICE: The significant increase in the risk of catheter failure per hour may warrant close and frequent inspection of insertion site during the first 38 hr.


Assuntos
Cateterismo Periférico/efeitos adversos , Cateteres de Demora/efeitos adversos , Falha de Equipamento/estatística & dados numéricos , Adulto , Cateterismo Periférico/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Fatores de Tempo
20.
J Infus Nurs ; 42(5): 228-236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31464830

RESUMO

Nursing practice and institutional policies regarding short peripheral catheter (SPC) flushing vary. These variations result in a lack of understanding about the factors that influence nurses' SPC flushing practices and leave their effect on outcomes unexplored-information that could potentially enhance nurses' clinical education, institutional policy efforts, and patient care. Using a mixed-methods design, this study examined SPC flushing practices and outcomes among a cohort of medical-surgical nurses and explored their rationale for flushing. Trends were noted in the timing of flushes, and the factors that influenced nurses' SPC flushing practices included patient acuity, experience, and workload.


Assuntos
Cateterismo Periférico/enfermagem , Educação em Enfermagem , Assistência ao Paciente/normas , Padrões de Prática em Enfermagem/normas , Competência Clínica/normas , Grupos Focais , Humanos , Enfermagem Médico-Cirúrgica , Gravidade do Paciente , Inquéritos e Questionários , Fatores de Tempo
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