RESUMO
BACKGROUND: A vascular access team (VAT) was created in 2018 with the aim of improving vascular access and reducing complications associated with catheters. The impact of the introduction of a VAT in the insertion and maintenance of peripheral insertion central catheters (PICCs) was assessed. The cost-benefit associated with the use of a VAT was evaluated and the satisfaction of patients and professionals interacting with the VAT was measured. METHODS: In a prospective study, 275 PICCs inserted by the VAT were assessed for their impact on complications. PICCs were implanted with maximum barrier measures using an ultrasound with IC-ECG. Also, patient and professional satisfaction have been analysed thought a questionnaire over the phone or online, and hospital financial data was used to assess the cost impact of the insertion methodology followed by the VAT versus Anaesthesia Service. RESULTS: The thrombosis rate was 2.5% (7) and the bacteraemia rate was 1.1% (3). The use of the IC-ECG was correlated with a lower complication than the RX + IC-ECG (OR = 3.28, p = 0.021). In addition, there was a high level of perceived satisfaction for the patients surveyed and for the healthcare professionals involved in the care and management of these devices. The calculated saving for the implementation of the VAT was 61.81% compared with PICCs implanted in Anaesthesia Service. CONCLUSION: Low complication rates and high overall satisfaction scores in patients and professionals were observed, showing that a specialist VAT can have a positive impact in the insertion of PICCs and which also has a clear economic benefit.
Assuntos
Cateterismo Venoso Central , Cateterismo Periférico , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Cateterismo Periférico/efeitos adversos , Análise Custo-Benefício , Humanos , Estudos ProspectivosRESUMO
Introducción: El uso de Catéteres Centrales de Inserción Periférica (PICC) ha ido creciendo en la práctica clínica debido a la preocupación por incrementar la seguridad del paciente, la facilidad de implantación de dichos dispositivos y el número reducido de complicaciones que presentan. Con ello ha aumentado también la necesidad de crear Equipos de Terapia Intravenosa (ETI) para potenciar la implantación de prácticas adecuadas. El Complejo Hospitalario de Navarra (CHN) ha creado una Unidad de Terapia Intravenosa (UTI) respaldada por un equipo multidisciplinar desde enero de 2018. Objetivo: Presentar antecedentes, la trayectoria, la implantación y los resultados de la Unidad de Terapia Intravenosa (UTI) en el CHN. Material y método: Se presenta una descripción de la trayectoria de creación e implantación de la UTI en el CHN y su funcionamiento durante un periodo de 3 meses (enero-marzo de 2018). Resultados: En el año 2015 el CHN se incorporó al proyecto BPSO(R) con la implantación de la guía «Cuidados y mantenimiento de los accesos vasculares para reducir las complicaciones». A partir de las recomendaciones de dicha guía para la organización se trabajó para la creación de la Unidad de Terapia Intravenosa. Desde el inicio de su actividad, la UTI ha implantado un total de 136 dispositivos entre catéteres PICC y líneas medias, siendo la gran mayoría PICC (113) frente a 23 líneas medias. Discusión: Se ha conseguido proporcionar cuidados de calidad a los usuarios de este tipo de dispositivos. Ha mejorado su calidad de vida, se han evitado las punciones continuas, se ha preservado su capital venoso y ha disminuido la hospitalización convencional. Conclusión: Se reafirma la necesidad de formar profesionales especializados en colocación, cuidado y mantenimiento de accesos vasculares como el PICC
Introduction: The use of Peripheral Insertion Central Catheters (PICC), has been growing in clinical practice due to the concern to increase the safety of the patient, the ease of implantation of said devices and the reduced number of complications they present and with it the need to create Intravenous Therapy Teams (ITT) to promote the implementation of appropriate practices. The Hospital Center of Navarra (HCN) has created an Intravenous Therapy Unit (ITU), supported by a multidisciplinary team since January 2018. Objective: Present background, trajectory, implementation and results of the ITU in the HCN. Material and method: A description of the trajectory of creation and implantation of the ITU in the CHN, and its operation during a period of 3 months (January-March 2018) is presented. Results: In 2015, the HCN joined the BPSO(R) Project with the implementation of the guide «Care and maintenance of vascular acces to reduce complications». From the recomendation of this guide for the organization we worked for the creation of the Intravenous Therapy Unit. Since the beginning of its activity, the ITU has implanted a total of 136 devices between PICC and midline catheters, with the vast majority being PICC (113) compared to 23 midlines. Discussion: We have managed to provide quality care to users of this type of device, improving their quality of life, avoiding continuous punctures, preserving their venous capital and reducing conventional hospitalization. Conclusion: The need to form specialized professionals in placement, care and maintenance of vascular accesses such as the PICC is reaffirmed