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1.
BMC Infect Dis ; 19(1): 558, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31242860

RESUMO

BACKGROUND: Amphotericin-induced phlebitis is a common infusion-related reaction in patients managed for cryptococcal meningitis. High-quality nursing care is critical component to successful cryptococcosis treatment. We highlight the magnitude and main approaches in the management of amphotericin-induced phlebitis and the challenges faced in resource-limited settings. METHODS: We prospectively determined the incidence of amphotericin-induced phlebitis during clinical trials in Kampala, Uganda from 2013 to 2018. We relate practical strategies and challenges faced in clinical management of phlebitis. RESULTS: Overall, 696 participants were diagnosed with HIV-related cryptococcal meningitis. Participants received 7-14 doses of intravenous (IV) amphotericin B deoxycholate 0.7-1.0 mg/kg/day for induction therapy through peripheral IV lines at a concentration of 0.1 mg/mL in 5% dextrose. Overall, 18% (125/696) developed amphotericin-induced phlebitis. We used four strategies to minimize/prevent the occurrence of phlebitis. First, after every dose of amphotericin, we gave one liter of intravenous normal saline. Second, we rotated IV catheters every three days. Third, we infused IV amphotericin over 4 h. Finally, early ambulation was encouraged to minimize phlebitis. To alleviate phlebitis symptoms, warm compresses were used. In severe cases, treatment included topical diclofenac gel and oral anti-inflammatory medicines. Antibiotics were used only when definite signs of infection developed. Patient/caregivers' education was vital in implementing these management strategies. Major challenges included implementing these interventions in participants with altered mental status and limited access to topical and oral anti-inflammatory medicines in resource-limited settings. CONCLUSIONS: Amphotericin-induced phlebitis is common with amphotericin, yet phlebitis is a preventable complication even in resource-limited settings. TRIAL REGISTRATION: The ASTRO-CM trial was registered prospectively. ClincalTrials.gov : NCT01802385 ; Registration date: March 1, 2013; Last verified: February 14, 2018.


Assuntos
Anfotericina B/efeitos adversos , Infecções por HIV/tratamento farmacológico , Meningite Criptocócica/tratamento farmacológico , Flebite/induzido quimicamente , Flebite/terapia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Antifúngicos/efeitos adversos , Ácido Desoxicólico/administração & dosagem , Ácido Desoxicólico/efeitos adversos , Combinação de Medicamentos , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Recursos em Saúde/economia , Humanos , Incidência , Infusões Intravenosas , Masculino , Meningite Criptocócica/complicações , Meningite Criptocócica/epidemiologia , Flebite/epidemiologia , Áreas de Pobreza , Uganda/epidemiologia
2.
Rev Gaucha Enferm ; 40(spe): e20180317, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31038602

RESUMO

OBJECTIVE: Analyze incident notifications related to the patient's safety. METHOD: Cross-sectional study with quantitative approach, based on data from the risk Management of a hospital complex, located in northwest São Paulo, from August 2015 to July 2016. RESULTS: 4,691 notifications were analyzed. Nurses were the professionals who notified the most (71%), followed by physicians (8%). The most frequent period in which the notifications occurred was the daytime. There was significant difference in the proportion of notifications between the days of the week. The notifications were classified by reason and the most prevalent were those related to medication (17%), followed by skin lesions (15%), and phlebitis (14%). The highest frequency of notifications occurred in the hospitalization units. In relation to severity, 344 events caused damage to the patient, most of which were of mild intensity (65%). CONCLUSION: Spontaneous notifications are an important source of information, and highlight the magnitude of the problem related to health incidents.


Assuntos
Segurança do Paciente , Gestão de Riscos , Acidentes por Quedas/estatística & dados numéricos , Brasil , Estudos Transversais , Unidades Hospitalares , Humanos , Erros de Medicação/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Flebite/epidemiologia , Melhoria de Qualidade , Estudos Retrospectivos , Gestão de Riscos/métodos , Gestão de Riscos/organização & administração , Gestão de Riscos/estatística & dados numéricos , Dermatopatias/epidemiologia , Fatores de Tempo
4.
Crit Care Nurse ; 39(1): e1-e12, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30710042

RESUMO

BACKGROUND: Intravenous amiodarone is the gold-standard treatment for arrhythmias, but phlebitis is a common adverse effect. OBJECTIVES: To determine the incidence and contributing factors of amiodarone-induced phlebitis and examine phlebitis severity. METHODS: A systematic review was conducted of articles published before February 2016 in the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, MEDLINE, Embase, Web of Science, and gray databases (Bielefeld, Lenus, EUGrey, RIAN, and DART). All studies in which amiodarone-induced phlebitis was a primary or secondary outcome were included. Meta-analysis was not appropriate because of study heterogeneity. Studies of the same contributing factors were analyzed together. RESULTS: In the 20 included studies, phlebitis incidence ranged from 0% to 85%. Increasing the infusion concentration from 1.2 mg/mL to 1.8 mg/mL increased the phlebitis rate (P < .001). Total amiodarone doses greater than 1 g resulted in higher phlebitis rates than did doses less than 0.45 mg (P < .001). Most infusion durations and rates were not correlated with phlebitis incidence. However, phlebitis incidence was lower with bolus administration than with longer infusions (P = .002). The use of in-line filters and nursing guidelines significantly reduced phlebitis rates (P < .001) and phlebitis severity. The most common phlebitis severity grades, in descending order, were 0, 1, 2, 3, and 4. CONCLUSIONS: Understanding factors that increase the risk of amiodarone-induced phlebitis can guide better practice. In-line filters and nursing guidelines should always be implemented when administering intravenous amiodarone. Increased surveillance is required when higher dosages and concentrations are used.


Assuntos
Amiodarona/administração & dosagem , Amiodarona/efeitos adversos , Antiarrítmicos/administração & dosagem , Antiarrítmicos/efeitos adversos , Flebite/induzido quimicamente , Humanos , Incidência , Infusões Intravenosas , Flebite/epidemiologia , Índice de Gravidade de Doença
5.
Cochrane Database Syst Rev ; 1: CD007798, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-30671926

RESUMO

BACKGROUND: US Centers for Disease Control guidelines recommend replacement of peripheral intravenous catheters (PIVC) no more frequently than every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bloodstream infection. Catheter insertion is an unpleasant experience for patients and replacement may be unnecessary if the catheter remains functional and there are no signs of inflammation or infection. Costs associated with routine replacement may be considerable. This is the third update of a review first published in 2010. OBJECTIVES: To assess the effects of removing peripheral intravenous catheters when clinically indicated compared with removing and re-siting the catheter routinely. SEARCH METHODS: The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 18 April 2018. We also undertook reference checking, and contacted researchers and manufacturers to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials that compared routine removal of PIVC with removal only when clinically indicated, in hospitalised or community-dwelling patients receiving continuous or intermittent infusions. DATA COLLECTION AND ANALYSIS: Three review authors independently reviewed trials for inclusion, extracted data, and assessed risk of bias using Cochrane methods. We used GRADE to assess the overall evidence certainty. MAIN RESULTS: This update contains two new trials, taking the total to nine included studies with 7412 participants. Eight trials were conducted in acute hospitals and one in a community setting. We rated the overall certainty of evidence as moderate for most outcomes, due to serious risk of bias for unblinded outcome assessment or imprecision, or both. Because outcome assessment was unblinded in all of the trials, none met our criteria for high methodological quality.Primary outcomesSeven trials (7323 participants), assessed catheter-related bloodstream infection (CRBSI). There is no clear difference in the incidence of CRBSI between the clinically indicated (1/3590) and routine change (2/3733) groups (risk ratio (RR) 0.61, 95% confidence interval (CI) 0.08 to 4.68), low-certainty evidence (downgraded twice for serious imprecision).All trials reported incidence of thrombophlebitis and we combined the results from seven of these in the analysis (7323 participants). We excluded two studies in the meta-analysis because they contributed to high heterogeneity. There is no clear difference in the incidence of thrombophlebitis whether catheters were changed according to clinical indication or routinely (RR 1.07, 95% CI 0.93 to 1.25; clinically indicated 317/3590; 3-day change 307/3733, moderate-certainty evidence, downgraded once for serious risk of bias). The result was unaffected by whether the infusion was continuous or intermittent. Six trials provided thrombophlebitis rates by number of device days (32,709 device days). There is no clear difference between groups (RR 0.90, 95% CI 0.76 to 1.08; clinically indicated 248/17,251; 3-day change 236/15,458; moderate-certainty evidence, downgraded once for serious risk of bias).One trial (3283 participants), assessed all-cause blood stream infection (BSI). We found no clear difference in the all-cause BSI rate between the two groups (RR 0.47, 95% CI 0.15 to 1.53; clinically indicated: 4/1593 (0.02%); routine change 9/1690 (0.05%); moderate-certainty evidence, downgraded one level for serious imprecision).Three trials (4244 participants), investigated costs; clinically indicated removal probably reduces device-related costs by approximately AUD 7.00 compared with routine removal (MD -6.96, 95% CI -9.05 to -4.86; moderate-certainty evidence, downgraded once for serious risk of bias).Secondary outcomesSix trials assessed infiltration (7123 participants). Routine replacement probably reduces infiltration of fluid into surrounding tissues compared with a clinically indicated change (RR 1.16 (95% CI 1.06 to 1.26; routine replacement 747/3638 (20.5%); clinically indicated 834/3485 (23.9%); moderate-certainty evidence, downgraded once for serious risk of bias).Meta-analysis of seven trials (7323 participants), found that rates of catheter failure due to blockage were probably lower in the routine-replacement group compared to the clinically indicated group (RR 1.14, 95% CI 1.01 to 1.29; routine-replacement 519/3733 (13.9%); clinically indicated 560/3590 (15.6%); moderate-certainty evidence, downgraded once for serious risk of bias).Four studies (4606 participants), reported local infection rates. It is uncertain if there are differences between groups (RR 4.96, 95% CI 0.24 to 102.98; clinically indicated 2/2260 (0.09%); routine replacement 0/2346 (0.0%); very low-certainty evidence, downgraded one level for serious risk of bias and two levels for very serious imprecision).One trial (3283 participants), found no clear difference in the incidence of mortality when clinically indicated removal was compared with routine removal (RR 1.06, 95% CI 0.27 to 4.23; low-certainty evidence, downgraded two levels for very serious imprecision).One small trial (198 participants) reported no clear difference in device-related pain between clinically indicated and routine removal groups (MD -0.60, 95% CI -1.44 to 0.24; low-certainty evidence, downgraded one level for serious risk of bias and one level for serious imprecision).The pre-planned outcomes 'number of catheter re-sites per patient', and 'satisfaction' were not reported by any studies included in this review. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence of no clear difference in rates of CRBSI, thrombophlebitis, all-cause BSI, mortality and pain between clinically indicated or routine replacement of PIVC. We are uncertain if local infection is reduced or increased when catheters are changed when clinically indicated. There is moderate-certainty evidence that infiltration and catheter blockage is probably lower when PIVC are changed routinely; and moderate-certainty evidence that clinically indicated removal probably reduces device-related costs. The addition of two new trials for this update found no further evidence to support changing catheters every 72 to 96 hours. Healthcare organisations may consider changing to a policy whereby catheters are changed only if there is a clinical indication to do so, for example, if there were signs of infection, blockage or infiltration. This would provide significant cost savings, spare patients the unnecessary pain of routine re-sites in the absence of clinical indications and would reduce time spent by busy clinicians on this intervention. To minimise PIVC-related complications, staff should inspect the insertion site at each shift change and remove the catheter if signs of inflammation, infiltration, occlusion, infection or blockage are present, or if the catheter is no longer needed for therapy.


Assuntos
Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Periférico/instrumentação , Remoção de Dispositivo/normas , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/economia , Cateteres de Demora/efeitos adversos , Fidelidade a Diretrizes , Humanos , Incidência , Flebite/epidemiologia , Flebite/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Tromboflebite/epidemiologia , Tromboflebite/etiologia , Fatores de Tempo
6.
J Clin Nurs ; 28(9-10): 1585-1599, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30589945

RESUMO

AIMS AND OBJECTIVES: To determine the incidence, severity and risk factors of peripheral intravenous cannula-induced complications. BACKGROUND: Peripheral venous cannulation in hospitalised patients may cause complications such as phlebitis, infiltration, occlusion and dislodgement. A review of the literature reveals the discrepancy in their incidence and identification of a wide range of risk factors, whereas the data on the occurrence and degree of severity are insufficient. DESIGN: An observational prospective study. METHODS: The study observed 1,428 peripheral intravenous cannula insertion among 368 adult patients hospitalised at the tertiary healthcare clinics. The data collection and analysis included patients' medical data and the data related to each cannula (including placement, monitoring and the reasons for removal), as well as the data on the type of administered medications and solutions. Reporting of this research adheres to the STROBE guidelines. RESULTS: Phlebitis ranked first among complications with occurrence of 44%, followed by infiltration of 16.3%, while the incidence of occlusion and catheter dislodgement was 7.6% and 5.6%, respectively. In assessing the occurrence of phlebitis, multivariate analysis highlighted the presence of comorbidity, current infection, catheter size, time in situ and the number of administrations of infusion solutions associated with risk, whereas 20-gauge catheter, two or more attempts at cannulation and administration of a high-risk solutions during the first day have been singled out with regard to infiltration. As for the severity, the most common was medium stage of phlebitis, whereas grade 2 was most commonly observed for infiltration. CONCLUSION: The incidence of infiltration, occlusion and dislodgment is almost congruent with the average incidence of previous studies. However, the incidence and degree of severity associated with the occurrence of phlebitis were significantly higher. RELEVANCE TO CLINICAL PRACTICE: The results of the study draw attention to vulnerable groups of patients, cannula-specific and pharmacological risk factors for the development of peripheral intravenous cannula-induced complications.


Assuntos
Infecções Relacionadas a Cateter/etiologia , Cateterismo Periférico/efeitos adversos , Cateterismo/efeitos adversos , Flebite/etiologia , Administração Intravenosa , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Relacionadas a Cateter/epidemiologia , Feminino , Humanos , Incidência , Infusões Intravenosas , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Flebite/epidemiologia , Estudos Prospectivos , Fatores de Risco
7.
Rev. gaúch. enferm ; 40(spe): e20180317, 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1004116

RESUMO

Resumo OBJETIVO Analisar as notificações de incidentes relacionados à segurança do paciente. MÉTODOS Estudo transversal com abordagem quantitativa, baseado nos dados do Gerenciamento de Risco de um complexo hospitalar, localizado no noroeste paulista, de agosto/2015 a julho/2016. RESULTADOS Foram analisadas 4.691 notificações. O enfermeiro foi a categoria profissional que mais notificou (71%), seguido do médico (8%). O período mais frequente em que ocorreram as notificações foi o diurno. Houve diferença significativa da proporção de notificações entre os dias da semana. As notificações foram classificadas por motivo, com destaque para os medicamentos (17%), seguido de lesões de pele (15%) e flebite (14%). A maior frequência de notificações ocorreu nas unidades de Internação. Quanto à gravidade 344 eventos ocasionaram dano ao paciente, sendo a maioria de intensidade leve (65%). CONCLUSÃO As notificações espontâneas são uma importante fonte de informações e evidenciam a magnitude do problema relacionado aos incidentes em saúde.


Resumen OBJETIVO Analizar las notificaciones de incidentes relacionados con la seguridad del paciente. MÉTODOS Estudio transversal con abordaje cuantitativo, basado en los datos del Gestión de Riesgos de un complejo hospitalario, ubicado em el noroeste paulista, de agosto de 2015 a julio de 2016. RESULTADOS Se analizaron 4.691 notificaciones. El enfermero fue la categoría profesional que más notificó (71%), seguido del médico (8%). El período más frecuente en que ocurrieron las notificaciones fue el diurno. Hubo una diferencia significativa de la proporción de notificaciones entre los días de la semana. Las notificaciones se clasificaron por motivo, con destaque para los medicamentos (17%), seguido de lesiones de piel (15%), flebitis (14%). La mayor frecuencia de notificaciones ocurrió en las unidades de Internación. En cuanto a la gravedad 344 eventos ocasionaron daño al paciente, siendo la mayoría de intensidad leve (65%). CONCLUSIÓN Las notificaciones espontáneas son una importante fuente de información, y evidencia la magnitud del problema relacionado con los incidentes en salud.


Abstract OBJECTIVE Analyze incident notifications related to the patient's safety. METHOD Cross-sectional study with quantitative approach, based on data from the risk Management of a hospital complex, located in northwest São Paulo, from August 2015 to July 2016. RESULTS 4,691 notifications were analyzed. Nurses were the professionals who notified the most (71%), followed by physicians (8%). The most frequent period in which the notifications occurred was the daytime. There was significant difference in the proportion of notifications between the days of the week. The notifications were classified by reason and the most prevalent were those related to medication (17%), followed by skin lesions (15%), and phlebitis (14%). The highest frequency of notifications occurred in the hospitalization units. In relation to severity, 344 events caused damage to the patient, most of which were of mild intensity (65%). CONCLUSION Spontaneous notifications are an important source of information, and highlight the magnitude of the problem related to health incidents.


Assuntos
Humanos , Erros de Medicação , Recursos Humanos em Hospital/estatística & dados numéricos , Flebite/epidemiologia , Gestão de Riscos/métodos , Gestão de Riscos/organização & administração , Gestão de Riscos/estatística & dados numéricos , Dermatopatias/epidemiologia , Fatores de Tempo , Acidentes por Quedas/estatística & dados numéricos , Brasil , Estudos Transversais , Estudos Retrospectivos , Melhoria de Qualidade , Unidades Hospitalares , Erros de Medicação/estatística & dados numéricos
8.
Eur J Pediatr ; 177(11): 1719-1726, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30191302

RESUMO

Peripheral intravenous cannula (PIVC) insertion is one of the most common invasive procedures performed in neonates and is frequently associated with adverse events. There are no studies in the neonatal population looking at the possibility of reducing the risk of PIVC-related complications by elective replacement of PIVC. A randomised, non-blinded, control trial was conducted in a tertiary level neonatal unit in Melbourne, Australia, to examine rates of extravasation in neonates with elective replacement of PIVC as compared to standard practice. Neonates born at 32 weeks of gestation or more were randomly assigned to have their PIVC replaced electively (every 72-96 h) or when clinically indicated in a 1:1 allocation ratio after parental consent. Primary outcome studied was rate of extravasation. Secondary outcomes included rates of phlebitis, leakage or spontaneous dislodgement of PIVC. One hundred thirteen infants were enrolled. Extravasation was noted in 33 (60%) of standard practice group vs. 28 (48.3%) of elective replacement (RR 0.80, CI 0.57-1.13, p = 0.21) infants. Time to first extravasation was similar between the groups (hazard ratio 0.69, CI 0.42-1.15). Extravasation events per 1000 IV hours were also similar between groups. Similar results were seen by both intention to treat and per protocol analyses. There was an increase in leaking rates (HR1.98, CI 1.03-3.81, p = 0.04) in the elective group, while phlebitis and spontaneous dislodgement rates were similar to standard group.Conclusion: Elective replacement of PIVC in neonates is not associated with reduction in extravasation rates.Trial registration: This trial has been registered with the Australian and New Zealand Clinical Trials Register. Identifier: ACTRN12615000827538. What is Known: • The reported incidence of extravasation injury is as high as 70% in the neonatal and paediatric population and has an association with cannula dwell time. • Adult studies have done to look at the possibility of reducing intravenous cannula-related complications with routine replacement of the cannulas but no similar studies have been done in the neonatal population. What is New: • Routine replacement of intravenous cannula in neonates between 72 and 96 h of use does not reduce the rate of extravasation injuries. • There might be some added complications associated with such a practice.


Assuntos
Cânula/efeitos adversos , Cateterismo Periférico/efeitos adversos , Remoção de Dispositivo/métodos , Administração Intravenosa , Austrália , Cateterismo Periférico/métodos , Remoção de Dispositivo/efeitos adversos , Feminino , Humanos , Recém-Nascido , Estimativa de Kaplan-Meier , Masculino , Flebite/epidemiologia , Flebite/etiologia , Estudos Prospectivos
9.
Przegl Epidemiol ; 72(2): 205-213, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30111078

RESUMO

INTRODUCTION: Peripheral veins cannulation is one of the most frequently executed medical procedures. Primary blood infections which might be the result of peripheral veins cannulation are serious issue that medical care centers all over the world must consider. Medical personnel can choose the area of cannulation thanks to the availability of peripheral veins. Duration of cannulation longer than 72 ­ 96 hours can cause peripheral veins inflammation. AIM OF THE STUDY: Assay of observation sheets of peripheral cannulation. MATERIAL AND METHODS: The study included 14926 patients, who were hospitalized in 2016 in the Municipal Hospital in Zabrze. Observations of each cannulation were recorded in observation sheets for peripheral veins cannulation. Patients age median and duration of cannulation median were calculated basing on 782 observation sheets with registered inflammation of the area of cannulation. RESULTS: Right forearm was area where the most (19%) of vein inflammation occurred. First level of veins inflammation according to criteria of veins inflammation intensity evaluation was the most frequent (90,7%). Duration of venous cannulation median indicated that most of the catheters were removed on the second day. When veins inflammation was diagnosed, the most frequent action was to remove the catheter. During 12 hours 697 observations of cannulation were proceeded. 548 observations of intravenous cannulation were proceeded once for 24 hours. CONCLUSIONS: Right forearm was area where the most of cannulations occurred. Frequent observation of the area of peripheral venous cannulation allows quick inflammation symptoms detection.


Assuntos
Cateterismo Periférico/efeitos adversos , Flebite/epidemiologia , Idoso , Feminino , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Flebite/etiologia , Polônia/epidemiologia , Fatores de Tempo
10.
Rev Gaucha Enferm ; 38(4): e57489, 2018 Jun 07.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29933415

RESUMO

OBJECTIVE: To describe the scientific evidence published in literature regarding the risk factors for the development of phlebitis. METHOD: Integrative literature review with the inclusion of 14 original articles found in the LILACS, Scielo and Pubmed bases from January 2004 to April 2015, analyzed by levels of evidence and frequency, associated factors, degree and treatment of phlebitis. RESULTS: The frequency / incidence / minimum rate of phlebitis was 3% and the maximum was 59.1%. Most articles (57.14%) reported an association of phlebitis with risk factors, including the dwell time, puncture site and / or anatomical region, hospitalization period, number of accesses, reason for removal, sex, antibiotics, intermittent maintenance and emergency insertion. CONCLUSIONS: The need for standardizing the quantification of this event and a weak connection between the risk factors associated with phlebitis were identified. Further studies need to be developed in order to grant a real understanding of this disease in the daily routines of a hospital.


Assuntos
Flebite/etiologia , Antibacterianos/efeitos adversos , Bibliometria , Cateterismo Periférico/efeitos adversos , Suscetibilidade a Doenças , Estudos Epidemiológicos , Medicina Baseada em Evidências , Feminino , Hospitalização , Humanos , Masculino , Estudos Observacionais como Assunto , Flebite/epidemiologia , Flebite/enfermagem , Flebotomia/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Veias/lesões
11.
J Infus Nurs ; 41(4): 260-263, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29958263

RESUMO

This study was undertaken to calculate the incidence of 8 signs and symptoms used for the diagnosis of phlebitis with peripheral intravenous catheters, or short peripheral catheters, and the level of correlation between them. A total of 22 789 daily observations of 6 signs (swelling, erythema, leakage, palpable venous cord, purulent discharge, and warmth) and 2 symptoms (pain and tenderness) were analyzed of 5907 catheter insertion sites. Most signs and symptoms of phlebitis occurred only occasionally or rarely; the incidence of tenderness was highest (5.7%). Correlations were mostly low; warmth correlated strongly with tenderness, swelling, and erythema.


Assuntos
Cateterismo Periférico/efeitos adversos , Cateteres de Demora/efeitos adversos , Flebite/diagnóstico , Flebite/enfermagem , Remoção de Dispositivo , Feminino , Humanos , Incidência , Masculino , Recursos Humanos de Enfermagem no Hospital , Flebite/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
12.
Metas enferm ; 21(5): 64-69, jun. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172695

RESUMO

Objetivo: determinar la influencia de la técnica de colocación de catéteres centrales de inserción periférica (PICC), ecoguiada frente a punción ciega, sobre la incidencia de flebitis y otras complicaciones en pacientes oncológicos. Método: estudio analítico observacional de cohorte retrospectivo (grupo punción ciega versus grupo con técnica ecoguiada). Se incluyeron, 168 pacientes a los que se les colocó un PICC durante los años 2013 a 2015 (seleccionados por muestreo aleatorio simple), con punción ciega (n= 114) o ecoguiada (n= 54) en el Hospital de Día del ICO-Hospital Duran i Reynals (Barcelona). Las variables estudiadas fueron la incidencia de flebitis y otras complicaciones asociadas al catéter, el tiempo hasta la aparición de las complicaciones, el motivo de retirada y el tiempo de duración del catéter. Resultados: la edad media de los pacientes en ambos grupos fue similar (59,3 en grupo punción ciega y 59,7 años en grupo con técnica ecoguiada). El tumor más habitual fue el cáncer de cabeza y cuello, aunque con diferencias significativas en la distribución de los mismos entre ambos grupos. La flebitis fue la complicación más incidente. Ocurrió en el 16,7% del grupo con punción ciega frente al 1,8% en colocación ecoguiada (RR= 0,11; p= 0,012). La flebitis apareció de media a los 30 días (DE: 6,93) en los catéteres ecoguiados y a los 11 días (DE: 8,58) en los insertados sin ecógrafo (p= 0,002). Conclusiones: la implantación de la técnica ecoguiada para la inserción de PICC frente a la punción ciega se asocia a una reducción en la incidencia y en el tiempo de aparición de la flebitis


Objective: to determine the impact of the ultrasound-guided technique for peripherally-inserted central catheters (PICCs) vs. blind puncture, on the incidence of phlebitis and other complications in oncology patients. Method: an observational, analytical, retrospective cohort study (blind puncture arm vs. arm with ultrasound-guided technique). The study included 168 patients with a PICC inserted from 2013 to 2015 (selected through simple random sampling), with blind (n= 114) or ultrasound-guided puncture (n= 54) at the Day Hospital of the ICO-Hospital Duran i Reynals (Barcelona). The variables studied were: incidence of phlebitis and other catheter-related complications, time until the development of complications, reason for removal, and time of catheter duration. Results: the mean age of patients in both arms was similar (59.3 years in the blind puncture arm and 59.7 years in the arm with ultrasound-guided technique). The most frequent tumour was head and neck, though with significant differences in distribution between both arms. Phlebitis was the complication with the highest incidence, which occurred in 16.7% of the blind puncture arm vs. 1.8% with ultrasound-guided insertion (RR= 0.11; p= 0.012). The mean time for phlebitis development was 30 days (SD: 6.93) for ultrasound-guided catheters, and 11 days (SD: 8.58) for those inserted without ultrasound (p= 0.002). Conclusions: the implementation of the ultrasound-guided technique for PICC insertion vs. blind puncture was associated with a reduction in the incidence of phlebitis and the time to its development


Assuntos
Humanos , Cateterismo Periférico/efeitos adversos , Punções/efeitos adversos , Flebite/epidemiologia , Cateterismo Periférico/enfermagem , Punções/enfermagem , Ultrassonografia , Estudos de Coortes , Dispositivos de Acesso Vascular
13.
Rev Lat Am Enfermagem ; 26: e3002, 2018.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-29791668

RESUMO

OBJECTIVE: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). METHOD: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. RESULTS: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). CONCLUSION: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.


Assuntos
Cateterismo Periférico/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Flebite/epidemiologia , Flebite/etiologia , Veias/lesões , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
14.
J Stroke Cerebrovasc Dis ; 27(7): 1783-1788, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29519742

RESUMO

BACKGROUND: Nicardipine is frequently used in the treatment of hypertension for patients with acute stroke; however, its dosing is complicated by a high risk of phlebitis. In the present study, we examined whether restricting nicardipine concentration under a specific value could reduce the incidence of nicardipine-related phlebitis in patients with acute stroke. METHODS: Intravenous nicardipine-related phlebitis was retrospectively analyzed. From July 2015, a simple proposition was made to dilute maximum intravenous nicardipine concentration to lower than 130 µg/mL. The maximum intravenous nicardipine concentration and the incidence of phlebitis were compared between patients treated from July 2014 to June 2015 (preproposition group) and patients treated from July 2015 to June 2016 (postproposition group). RESULTS: A total of 300 patients (preproposition group, 138; postproposition group, 162) were included. The postproposition group demonstrated significantly lower maximum intravenous nicardipine concentration (in µg/mL, 76.9, 47.6-104.5 versus 130.4, 69.8-230.8; P < .001) and incidence of phlebitis (9.9%, 16/162 vs. 30%, 42/138; P < .001) than the preproposition group. Multivariable logistic regression analysis revealed that the maximum intravenous nicardipine concentration lower than 130 µg/mL (odds ratio [OR] .15; 95% confidence interval [CI] .06-.35; P < .001) and National Institutes of Health Stroke Scale on admission (OR .95; 95% CI .91-.99; P = .007) were the statistically significant independent factors for phlebitis, which indicated the usefulness of the proposition to dilute maximum intravenous nicardipine concentration to lower than 130 µg/mL. CONCLUSIONS: The simple and appropriate proposition about nicardipine administration lowered maximum nicardipine concentration and reduced the incidence of nicardipine-related phlebitis in patients with acute stroke.


Assuntos
Anti-Hipertensivos/administração & dosagem , Hipertensão/tratamento farmacológico , Nicardipino/administração & dosagem , Flebite/induzido quimicamente , Flebite/prevenção & controle , Acidente Vascular Cerebral/complicações , Administração Intravenosa , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/efeitos adversos , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Nicardipino/efeitos adversos , Flebite/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento
15.
Rev. enferm. UFPE on line ; 12(3): 745-752, mar. 2018. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-967384

RESUMO

Objetivo: verificar a incidência de flebites em pacientes adultos associando com característica sociodemográfica, internação hospitalar e punção venosa. Método: estudo quantitativo, descritivo, retrospectivo, realizado em um hospital da rede sentinela, por meio da notificação de eventos adversos no prontuário eletrônico, totalizando 176. Foram calculados a média e o desvio padrão para as variáveis quantitativas. A incidência de flebites foi calculada usando-se números absolutos e porcentagem. Parecer 1.050.829. Resultados: a incidência média de flebite foi 14,66 em 12 meses. A maioria dos pacientes era de homens, entre 61 e 80 anos, branca, casada, com ensino fundamental incompleto, aposentada, católica, do Sistema Único de Saúde, com internação <15 dias e punção venosa periférica com tempo <72h de inserção. A maioria dos enfermeiros não especificou a droga prescrita. Conclusão: a flebite ocorreu em pacientes com tempo de internação <15 dias e punção venosa <72h. A maioria das drogas não foi especificada, mas, quando descrita, era irritante. A conduta foi a retirada e a troca da punção e os pacientes receberam alta hospitalar. Este estudo demonstrou a necessidade da notificação correta de flebite pelos enfermeiros a fim de avaliar os riscos para melhorar a segurança do paciente.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Flebite , Flebite/epidemiologia , Condições Sociais , Notificação , Segurança do Paciente , Pacientes Internados , Cuidados de Enfermagem , Estudos Retrospectivos , Registros Eletrônicos de Saúde
16.
Am J Health Syst Pharm ; 75(5): 284-291, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29472509

RESUMO

PURPOSE: One institution's experience with use of peripheral i.v. (PIV) catheters for prolonged infusions of 3% sodium chloride injection at rates up to 100 mL/hr is described. METHODS: A prospective, observational, 13-month quality assurance project was conducted at an academic medical center to evaluate frequencies of patient and catheter phlebitis among adult inpatients who received both an infusion of 3% sodium chloride injection for a period of ≥4 hours through a dedicated PIV catheter and infusions of routine-care solutions (RCSs) through separate PIV catheters during the same hospital stay. RESULTS: Sixty patients received PIV infusions through a total of 291 catheters during the study period. The majority of patients (78%) received infusions of 3% sodium chloride injection for intracranial hypertension, with 30% receiving such infusions in the intensive care unit. Phlebitis occurred in 28 patients (47%) during infusions of 3% sodium chloride and 26 patients (43%) during RCS infusions (p = 0.19). Catheter phlebitis occurred in 73 catheters (25%), with no significant difference in the frequencies of catheter phlebitis with infusion of 3% sodium chloride versus RCSs (30% [32 of 106 catheters]) versus 22% [41 of 185 catheters]), p = 0.16). CONCLUSION: Patient and catheter phlebitis rates were not significantly different with infusions of 3% sodium chloride injection versus RCSs, suggesting that an osmolarity cutoff value of 900 mOsm/L for peripheral infusions of hypertonic saline solutions may not be warranted.


Assuntos
Flebite/induzido quimicamente , Flebite/epidemiologia , Solução Salina Hipertônica/administração & dosagem , Solução Salina Hipertônica/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Composição de Medicamentos , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Flebite/diagnóstico , Estudos Prospectivos , Cloreto de Sódio/administração & dosagem , Cloreto de Sódio/efeitos adversos
17.
Rev. latinoam. enferm. (Online) ; 26: e3002, 2018. tab
Artigo em Inglês | LILACS | ID: biblio-901933

RESUMO

ABSTRACT Objective: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). Method: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). Conclusion: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.


RESUMO Objetivo: determinar a taxa de incidência e os fatores de risco para os indicadores sensíveis aos cuidados de Enfermagem, flebite e infiltração, em pacientes portadores de cateteres venosos periféricos (CVPs). Método: estudo de coorte com 110 pacientes. Utilizou-se escalas para avaliar e documentar flebite e infiltração. Recolheram-se variáveis sociodemográficas, clínicas, relativas ao CVP, à medicação e à internação, bem como efetuou-se análise descritiva e inferencial, e modelação logística multivariada. Resultados: a taxa de incidência de flebite e infiltração foi de 43,2 e 59,7 por mil cateteres-dia, respectivamente. A maioria dos CVPs foi removida nas primeiras 24h devido a esses traumas vasculares. Foram fatores de risco para flebite o tempo de internação (p=0,042) e o número de cateteres inseridos (p<0,001), sendo para infiltração a piperacilina/tazobactan (p=0,024) e o número de cateteres inseridos (p<0,001). Conclusão: a investigação documentou a incidência de indicadores sensíveis aos cuidados de Enfermagem (flebite e infiltração) e evidenciou novos fatores de risco relacionados à infiltração. Possibilitou, também, uma reflexão sobre os cuidados de Enfermagem para prevenir esses traumas vasculares, as indicações e as contraindicações do CVP, tendo subsidiada a implementação do PICC nas práticas de Enfermagem como alternativa ao CVP.


RESUMEN Objetivos: determinar la tasa de incidencia y los factores de riesgo para los indicadores sensibles a los cuidados de Enfermería, flebitis e infiltración, en pacientes portadores de catéteres venosos periféricos (CVPs). Método: se trata de un estudio de cohorte entre 110 pacientes. Se utilizaron escalas para evaluar y documentar la flebitis y la infiltración. Se recogieron variables sociodemográficas y clínicas, relativas al CVP, a la medicación y a la internación. Se realizó un análisis descriptivo e inferencial, y modelación logística multivariada. Resultados: la tasa de incidencia de flebitis e infiltración fue de 43,2 y 59,7 por mil catéteres-día, respectivamente. Se removió la mayoría de los CVPs en las primeras 24 horas debido a dichos traumas vasculares. Los factores de riesgo para la flebitis fueron: el tiempo de internación (p=0,042) y el número de catéteres insertados (p<0,001); para la infiltración: la piperacilina/tazobactan (p=0,024) y el número de catéteres insertados (p<0,001). Conclusión: la investigación documentó la incidencia de indicadores sensibles a los cuidados de Enfermería (flebitis e infiltración) y evidenció nuevos factores de riesgo relacionados con la infiltración. Posibilitó, también, una reflexión sobre los cuidados de Enfermería para prevenir los traumas vasculares y sobre las indicaciones y contraindicaciones del CVP, con la implantación del PICC auxiliando en las prácticas de Enfermería como alternativa del CVP.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Flebite/etiologia , Flebite/epidemiologia , Cateterismo Periférico/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Fatores de Risco , Estudos de Coortes
18.
Rev. latinoam. enferm. (Online) ; 26: e3002, 2018. tab
Artigo em Inglês | BDENF - Enfermagem, LILACS | ID: biblio-901954

RESUMO

ABSTRACT Objective: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). Method: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). Conclusion: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.


RESUMO Objetivo: determinar a taxa de incidência e os fatores de risco para os indicadores sensíveis aos cuidados de Enfermagem, flebite e infiltração, em pacientes portadores de cateteres venosos periféricos (CVPs). Método: estudo de coorte com 110 pacientes. Utilizou-se escalas para avaliar e documentar flebite e infiltração. Recolheram-se variáveis sociodemográficas, clínicas, relativas ao CVP, à medicação e à internação, bem como efetuou-se análise descritiva e inferencial, e modelação logística multivariada. Resultados: a taxa de incidência de flebite e infiltração foi de 43,2 e 59,7 por mil cateteres-dia, respectivamente. A maioria dos CVPs foi removida nas primeiras 24h devido a esses traumas vasculares. Foram fatores de risco para flebite o tempo de internação (p=0,042) e o número de cateteres inseridos (p<0,001), sendo para infiltração a piperacilina/tazobactan (p=0,024) e o número de cateteres inseridos (p<0,001). Conclusão: a investigação documentou a incidência de indicadores sensíveis aos cuidados de Enfermagem (flebite e infiltração) e evidenciou novos fatores de risco relacionados à infiltração. Possibilitou, também, uma reflexão sobre os cuidados de Enfermagem para prevenir esses traumas vasculares, as indicações e as contraindicações do CVP, tendo subsidiada a implementação do PICC nas práticas de Enfermagem como alternativa ao CVP.


RESUMEN Objetivos: determinar la tasa de incidencia y los factores de riesgo para los indicadores sensibles a los cuidados de Enfermería, flebitis e infiltración, en pacientes portadores de catéteres venosos periféricos (CVPs). Método: se trata de un estudio de cohorte entre 110 pacientes. Se utilizaron escalas para evaluar y documentar la flebitis y la infiltración. Se recogieron variables sociodemográficas y clínicas, relativas al CVP, a la medicación y a la internación. Se realizó un análisis descriptivo e inferencial, y modelación logística multivariada. Resultados: la tasa de incidencia de flebitis e infiltración fue de 43,2 y 59,7 por mil catéteres-día, respectivamente. Se removió la mayoría de los CVPs en las primeras 24 horas debido a dichos traumas vasculares. Los factores de riesgo para la flebitis fueron: el tiempo de internación (p=0,042) y el número de catéteres insertados (p<0,001); para la infiltración: la piperacilina/tazobactan (p=0,024) y el número de catéteres insertados (p<0,001). Conclusión: la investigación documentó la incidencia de indicadores sensibles a los cuidados de Enfermería (flebitis e infiltración) y evidenció nuevos factores de riesgo relacionados con la infiltración. Posibilitó, también, una reflexión sobre los cuidados de Enfermería para prevenir los traumas vasculares y sobre las indicaciones y contraindicaciones del CVP, con la implantación del PICC auxiliando en las prácticas de Enfermería como alternativa del CVP.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Flebite/etiologia , Flebite/epidemiologia , Veias/lesões , Cateterismo Periférico/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Incidência , Fatores de Risco , Estudos de Coortes
19.
Am J Infect Control ; 45(10): 1139-1142, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28964346

RESUMO

BACKGROUND: The use of intravascular catheters is often complicated by phlebitis, which is associated with increased morbidity and extended duration of hospitalization. We conducted a study to investigate the impact of needleless intravenous access devices on the rate of phlebitis in peripheral venous catheters (PVCs). METHODS: We prospectively recruited patients in 2 phases. The first group was treated with a regular cap, and the second group was treated with a needleless connector. The incidence of catheter-related phlebitis (CRP) was recorded as the primary end point. RESULTS: A total of 620 PVCs using regular caps were inserted into 340 patients and CRP rates were recorded. In the second phase of the study, 169 PVCs using needleless connectors were inserted into 135 patients. In the group treated with the regular cap, the CRP rate was 60% compared with 7% in the group treated with the needleless cap (P <.001). Consequently, the number of catheter replacements was decreased from 1.9 on average to 1.3 (P <.001). In both phases, patients who developed phlebitis had a statistically significant longer mean hospitalization period (P <.001), as were patients in the regular cap group (P <.01). CONCLUSIONS: The use of needleless connectors was found to be associated with a significant reduction of CRP in peripheral veins in a surgery department setting. The decreased morbidity resulted in a lower number of catheter replacements and duration of hospitalization.


Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Flebite/epidemiologia , Flebite/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
20.
Int J Nurs Pract ; 23(6)2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28990241

RESUMO

AIM: The purpose of this study was to investigate the safety of clinically indicated peripheral intravenous catheters (PIVC) replacement intervals. BACKGROUND: Peripheral intravenous catheters are used internationally, including in China where PIVCs are routinely replaced every 72 to 96 hours. Despite some recent international evidence showing such routine replacement is unnecessary, developing countries such as China have no supporting data. METHOD: This cluster-randomized trial was conducted between December 2 and December 31, 2013, in 10 internal medicine wards and 10 surgery wards at a tertiary referral teaching hospital in Xiamen, China. Patients were randomly divided into an experimental group (PIVCs were replaced only when clinical indications appeared) and a control group (PIVCs were routinely changed every 72-96 hours). Per-protocol analysis and intention-to-treat analysis were used to analyse the data. Primary end point was the incidence of phlebitis. RESULTS: This study analysed the data of 1198 patients (553 patients in the experimental group and 645 patients in the control group). There were no catheter-related bloodstream infections or local infections in the 2 groups. The 2 groups showed no statistically significant differences in the incidence of phlebitis, catheter occlusion, infiltration, and accidental removal. CONCLUSIONS: Clinically indicated PIVC replacement is feasible, and it may reduce nursing staff workload and patient discomfort.


Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Cateteres de Demora/efeitos adversos , Flebite/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Remoção de Dispositivo , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
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