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Abstract
Introduction: An adequate development of arteriovenous fistulas is related to the state of the vasculature and the previous use of peripheral venous catheter (PVC).
Objective: To evaluate the impact of training in a multimodal strategy to reduce complications related to PVC in a nephrology hospitalization unit.
Material and Method: Quasi-experimental pre-post intervention study in patients with PVC in a nephrology hospitalization unit. The intervention was training in a multimodal strategy for PVC management based on 5 evidence-based measures. To determine the impact, the electronic medical records of the PVCs inserted in the 3 months prior to the training activity (PRE) versus 3 months later (POST) were analyzed. A descriptive and inferential analysis of the variables to be studied was performed.
Results: PVC studied: PRE n=96, POST n=120. Average number of PVC/patient: PRE 2.07 vs. POST 1.75 (p=0.02). Caliber: PRE 18G 1%, 20G 18%, 22G 80%, 24G 1%; POST 20G 20%, 22G 80% (p=NS). Average duration: PRE 192h, <7 days 26% vs POST 171h, <7 days 30% (p = NS). Withdrawal causes: High/not accurate PRE 41% vs POST 38% (p=NS), Phlebitis PRE 27% vs POST 13% (p=NS).
Conclusions: Training in a multimodal strategy has managed to reduce: number of PVC per patient, number of phlebitis, use of PVC of greater caliber and time that remain inserted. A multimodal strategy on the PVCs management can help preserve the vascular tree in nephrological patients.
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References
- Mermel LA. Short-term Peripheral Venous Catheter–Related Bloodstream Infections: A Systematic Review. Clin Infect Dis. 2017;65(10):1757-62.
- Pasalioglu KB, Kaya H. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration. Pakistan J Med Sci. 2014;30(4):725-30.
- Ferrete-Morales C, Vázquez-Pérez MÁ, Sánchez-Berna M, Gilabert-Cerro I, Corzo-Delgado JE, Pineda-Vergara JA, et al. Incidencia de flebitis secundaria por catéter venoso de acceso periférico e impacto de un protocolo de manejo. Enfermería Clínica. 2010;20(1):3-9.
- Arias-Fernández L, Suérez-Mier B, Martínez-Ortega M del C, Lana A. Incidencia y factores de riesgo de flebitis asociadas a catéteres venosos periféricos. Enfermería Clínica. 2017;27(2):79-86.
- Mestre Roca G, Berbel Bertolo C, Tortajada Lopez P, Gallemi Samaranch G, Aguilar Ramirez MC, Caylà Buqueras J, et al. Assessing the influence of risk factors on rates and dynamics of peripheral vein phlebitis: An observational cohort study. Med Clin (Barc). 2012;139(5):185-91.
- Martínez Ortega C, Suárez Mier B. Flebitis Zero [Internet]. 2015. Disponible en: http://flebitiszero.com/site/.
- Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, et al. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Enferm Nefrol. 2018;21(Supl 1):S1-256.
- Blanco-Mavillard I, Bennasar-Veny M, De Pedro-Gómez JE, Moya-Suarez AB, Parra-Garcia G, Rodríguez-Calero MÁ, et al. Implementation of a knowledge mobilization model to prevent peripheral venous catheter-related adverse events: PREBACP study—a multicenter cluster-randomized trial protocol. Implement Sci. 2018;13(1):100.
- Gorski L, Hadaway L, Hagle ME, McGoldicks M, Orr M DD. Infusion therapy standards of practice. J Infus Nurs. 2016;39(Number 1s):s1-161.
- Guembe M, Pérez-Granda MJ, Capdevila JA, Barberán J, Pinilla B, Martín-Rabadán P, et al. Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments. J Hosp Infect. 2017;97(3):260-6.
- McGuire R, Norman E, Hayden I. Reassessing standards of vascular access device care: a follow-up audit. Br J Nurs. 2019;28(8):S4-12.
- Royal College of Nursing. Standards for infusion therapy 4 th edition 2016 [Internet]. 2016. Disponible en: https://www.rcn.org.uk/clinical-topics/infection-prevention-and-control/standards-for-infusion-therapy.
- Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;(86 Supl 1):S1-70.
- O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Supl 1):S1-34.
References
Mermel LA. Short-term Peripheral Venous Catheter–Related Bloodstream Infections: A Systematic Review. Clin Infect Dis. 2017;65(10):1757-62.
Pasalioglu KB, Kaya H. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration. Pakistan J Med Sci. 2014;30(4):725-30.
Ferrete-Morales C, Vázquez-Pérez MÁ, Sánchez-Berna M, Gilabert-Cerro I, Corzo-Delgado JE, Pineda-Vergara JA, et al. Incidencia de flebitis secundaria por catéter venoso de acceso periférico e impacto de un protocolo de manejo. Enfermería Clínica. 2010;20(1):3-9.
Arias-Fernández L, Suérez-Mier B, Martínez-Ortega M del C, Lana A. Incidencia y factores de riesgo de flebitis asociadas a catéteres venosos periféricos. Enfermería Clínica. 2017;27(2):79-86.
Mestre Roca G, Berbel Bertolo C, Tortajada Lopez P, Gallemi Samaranch G, Aguilar Ramirez MC, Caylà Buqueras J, et al. Assessing the influence of risk factors on rates and dynamics of peripheral vein phlebitis: An observational cohort study. Med Clin (Barc). 2012;139(5):185-91.
Martínez Ortega C, Suárez Mier B. Flebitis Zero [Internet]. 2015. Disponible en: http://flebitiszero.com/site/.
Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, et al. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Enferm Nefrol. 2018;21(Supl 1):S1-256.
Blanco-Mavillard I, Bennasar-Veny M, De Pedro-Gómez JE, Moya-Suarez AB, Parra-Garcia G, Rodríguez-Calero MÁ, et al. Implementation of a knowledge mobilization model to prevent peripheral venous catheter-related adverse events: PREBACP study—a multicenter cluster-randomized trial protocol. Implement Sci. 2018;13(1):100.
Gorski L, Hadaway L, Hagle ME, McGoldicks M, Orr M DD. Infusion therapy standards of practice. J Infus Nurs. 2016;39(Number 1s):s1-161.
Guembe M, Pérez-Granda MJ, Capdevila JA, Barberán J, Pinilla B, Martín-Rabadán P, et al. Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments. J Hosp Infect. 2017;97(3):260-6.
McGuire R, Norman E, Hayden I. Reassessing standards of vascular access device care: a follow-up audit. Br J Nurs. 2019;28(8):S4-12.
Royal College of Nursing. Standards for infusion therapy 4 th edition 2016 [Internet]. 2016. Disponible en: https://www.rcn.org.uk/clinical-topics/infection-prevention-and-control/standards-for-infusion-therapy.
Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;(86 Supl 1):S1-70.
O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Supl 1):S1-34.