Marta Ferraz-Torres, Elena Sancho-Sena, María Inés Corcuera-Martinez, Oscar Martinez-Garcia, María Belén Suarez-Mier
{"title":"Complications Related to the Securement Device in Peripheral Intravenous Catheters: A Randomized Study.","authors":"Marta Ferraz-Torres, Elena Sancho-Sena, María Inés Corcuera-Martinez, Oscar Martinez-Garcia, María Belén Suarez-Mier","doi":"10.1097/NAN.0000000000000561","DOIUrl":"10.1097/NAN.0000000000000561","url":null,"abstract":"<p><p>Studies have not demonstrated the effectiveness of the different types of dressings in reducing the rate of complications. The purpose of this study was to determine which type of dressing is most beneficial in reducing the rate of complications. A total of 281 patients requiring a peripheral intravenous catheter were randomized to receive partially reinforced dressings or fully reinforced dressings (dressings with integral catheter securement). Patients were followed throughout their entire catheter course, and complications included infection, occlusion, phlebitis, accidental dislodgement, extravasation, and medical adhesive-related skin injury. Catheter outcome data were compared to determine whether statistically significant differences existed between the 2 groups. The groups had equivalent demographic characteristics and catheter indications. The average securement time with partially reinforced dressings was 2.72 days, and that for fully reinforced dressings was 2.64 days. However, catheters secured with fully reinforced dressings were associated with fewer total complications, such as infectious phlebitis (P = .043) and accidental dislodgement (P = .03). The fully reinforced securement device significantly reduced the rate of complications related to accidental dislodgement of the device and cases of infectious phlebitis. The use of fully reinforced dressings could reduce catheter-associated complications and improve the quality of patient care.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 6","pages":"391-396"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabeth Lafuente Cabrero, Roser Terradas Robledo, Anna Civit Cuñado, Diana García Sardelli, Carla Molina Huerta, Laia Lacueva Perez, Purificacion Estevez Estevez, Cristina Esquinas, Avelina Tortosa
{"title":"The Midline Catheter Within the Context of Home Intravenous Antibiotic Treatment.","authors":"Elisabeth Lafuente Cabrero, Roser Terradas Robledo, Anna Civit Cuñado, Diana García Sardelli, Carla Molina Huerta, Laia Lacueva Perez, Purificacion Estevez Estevez, Cristina Esquinas, Avelina Tortosa","doi":"10.1097/NAN.0000000000000559","DOIUrl":"10.1097/NAN.0000000000000559","url":null,"abstract":"<p><p>Home intravenous antibiotic treatment (HIAT) consists of the administration of intravenous antibiotic therapy in the home of the patient. Short peripheral intravenous catheters have long been the first option for antimicrobial therapies. However, these devices are known for their short durability. At present, the midline catheter is one of the median duration devices most commonly used and recommended within the context of HIAT. The objective of this study was to evaluate the occurrence of complications related to midline catheters implanted by a vascular access team in patients undergoing HIAT within the context of home hospitalization. This was a prospective observational study, which consecutively included 77 patients. A total of 92 midline catheters were analyzed. The complications observed were device obstruction (8.7%), infiltration (3.3%), dislodgement (2.2%), and thrombosis (1.1%). Bivariate analysis showed that the pH of the drug and ertapenem administration were associated with catheter obstruction. The authors found a low prevalence of midline catheter-associated complications in patients undergoing HIAT. The use of antireflux needleless connectors should be considered to reduce obstructions. In addition, algorithms that include the variable of type of daily life activity should be developed for deciding the most appropriate catheter for home hospitalized patients receiving HIAT.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 6","pages":"369-376"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infiltration and Extravasation Risk with Midline Catheters: A Narrative Literature Review.","authors":"Lynn Hadaway, Lisa A Gorski","doi":"10.1097/NAN.0000000000000566","DOIUrl":"https://doi.org/10.1097/NAN.0000000000000566","url":null,"abstract":"<p><p>Midline catheters have recently gained popularity in clinical use, with a common reason being the reduction of central venous catheter use and central line-associated bloodstream infections. At the same time, the number of nononcology vesicant medications has increased, and midline catheters are frequently being used for infusions of vesicant medications. The Infusion Nurses Society (INS) Vesicant Task Force identified midline catheter use as a possible risk factor for extravasation and concluded that a thorough literature review was necessary. This review highlights the variations in catheter terminology and tip locations, the frequency of infiltration and extravasation in published studies, and case reports of infiltration and extravasation from midline catheters. It also examines the many clinical issues requiring evidence-based decision-making for the most appropriate type of vascular access devices. After more than 30 years of clinical practice with midline catheters and what appears to be a significant number of studies, evidence is still insufficient to answer questions about infusion of vesicant and irritant medications through midline catheters. Given the absence of consensus on tip location, inadequate evidence of clinical outcomes, and importance of patient safety, the continuous infusion of vesicants, all parenteral nutrition formulas, and infusates with extremes in pH and osmolarity should be avoided through midline catheters.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 5","pages":"324-346"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa A Gorski, Jennie Ong, Ruth Van Gerpen, Barb Nickel, Kathy Kokotis, Lynn Hadaway
{"title":"Development of an Evidence-Based List of Non-Antineoplastic Vesicants: 2024 Update.","authors":"Lisa A Gorski, Jennie Ong, Ruth Van Gerpen, Barb Nickel, Kathy Kokotis, Lynn Hadaway","doi":"10.1097/NAN.0000000000000568","DOIUrl":"https://doi.org/10.1097/NAN.0000000000000568","url":null,"abstract":"<p><p>Infiltration of a vesicant, called extravasation, can result in severe patient injuries. Recognition of vesicants and their relative risk of injury is essential to extravasation prevention, early recognition, and appropriate treatment. In this article, the Vesicant Task Force (VTF) updates the previously published Infusion Nurses Society (INS) vesicant list from 2017. The 2024 INS list diverges from earlier vesicant lists, such as the 2017 VTF list, by adopting a risk stratification approach based upon documented patient outcomes, in contrast to the reliance on expert consensus or only surrogate risk indicators, such as pH and osmolarity. The methodology used to create the updated list is explained, and the criteria for high- and moderate-risk vesicants and cautionary vesicants are defined.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 5","pages":"290-323"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Operational Definition of the Concept of Success in Peripheral Intravenous Catheterization in Hospitalized Children.","authors":"Luciano Marques Dos Santos, Denise Miyuki Kusahara, Elisa Conceição Rodrigues, Bruna Figueiredo Manzo, Mavilde da Luz Gonçalves Pedreira, Ariane Ferreira Machado Avelar","doi":"10.1097/NAN.0000000000000550","DOIUrl":"https://doi.org/10.1097/NAN.0000000000000550","url":null,"abstract":"<p><p>The objective of this study was to operationally define the concept of success in peripheral intravenous catheterization in children considering the Walker and Avant model. This is a methodological study, carried out through the following steps: concept selection, the definition of the analysis objective, identification of possible uses of the concept, determination of critical or essential attributes, construction of a model and opposite case, and identification of antecedents and consequences. The study was carried out based on a search in international databases from January to March 2021. The sample consisted of 47 studies conducted in 17 countries between 2008 and 2021. Five attributes, 20 antecedents, 10 consequences, and an empirical reference of the studied concept were identified. Also, 2 cases, model and opposite, were elaborated, and an operational definition of the concept was developed. The Walker and Avant method enabled the operationalization of the concept of success of peripheral intravenous catheterization in children based on attributes, antecedents and consequents, and model and opposite cases.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 4","pages":"224-232"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabell Renno, Raymund E Horch, Ingo Ludolph, Aijia Cai, Andreas Arkudas
{"title":"Vein Visualization With a Near Infrared Imaging Device and Its Impact on Students' and Nurses' Skills in an Academic Teaching University Hospital.","authors":"Isabell Renno, Raymund E Horch, Ingo Ludolph, Aijia Cai, Andreas Arkudas","doi":"10.1097/NAN.0000000000000552","DOIUrl":"https://doi.org/10.1097/NAN.0000000000000552","url":null,"abstract":"<p><p>Venipuncture for blood collection is frequently delegated to medical or nursing students, while their individual skills depend on the quality of teaching. The aim of this study was to evaluate the use of a near infrared imaging (NIR) system on the visualization of veins and its potential benefit for the education of medical personnel. Participants answered a questionnaire following standardized venipuncture for blood sampling with the help of an NIR device. Vein visibility with the NIR device and its ability to facilitate venipuncture were examined. Visibility of veins was significantly better with the NIR, and its direction was clearly delineated. Sixty-nine percent of the participants stated that they felt more secure with venipuncture after using the NIR device. Patients' individual factors limited the visibility of veins. The adjuvant use of an NIR system for venipuncture improves participants' subjective skills through visualization of veins and their direction.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 4","pages":"249-254"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leanne Tremain, Ari Collerman, Prathiba Harsha, Kwadjo Ntow, Cheryl Main, Janell Wohlgemut, Mark Brown, Ted Scott, Tim Dietrich
{"title":"Implementing a 4% EDTA Central Catheter Locking Solution as a Quality Improvement Project in a Large Canadian Hospital.","authors":"Leanne Tremain, Ari Collerman, Prathiba Harsha, Kwadjo Ntow, Cheryl Main, Janell Wohlgemut, Mark Brown, Ted Scott, Tim Dietrich","doi":"10.1097/NAN.0000000000000553","DOIUrl":"https://doi.org/10.1097/NAN.0000000000000553","url":null,"abstract":"<p><p>Oncology and critical care patients often require central vascular access devices (CVADs), which can make them prone to central line-associated bloodstream infections (CLABSIs) and thrombotic occlusions. According to the literature, CLABSIs are rampant and increased by 63% during the COVID-19 pandemic, highlighting the need for innovative interventions. Four percent ethylenediaminetetraacetic acid (4% EDTA) is an antimicrobial locking solution that reduces CLABSIs, thrombotic occlusions, and biofilm. This retrospective pre-post quality improvement project determined if 4% EDTA could improve patient safety by decreasing CLABSIs and central catheter occlusions. This was implemented in all adult cancer and critical care units at a regional cancer hospital and center. Before implementing 4% EDTA, there were 36 CLABSI cases in 16 months (27 annualized). After implementation, there were 6 cases in 6 months (12 annualized), showing a statistically significant decrease of 59% in CLABSIs per 1000 catheter days. However, there was no significant difference in occlusions (alteplase use). Eighty-eight percent of patients had either a positive or neutral outlook, while most nurses reported needing 4% EDTA to be available in prefilled syringes. The pandemic and nursing shortages may have influenced the results; hence, randomized controlled trials are needed to establish a causal relationship between 4% EDTA and CLABSIs and occlusions.</p>","PeriodicalId":46291,"journal":{"name":"Journal of Infusion Nursing","volume":"47 4","pages":"255-265"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}