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Objective:To construct an evaluation index system for the risk factors of peripheral venous indwelling catheter failure in adults.Methods:Through literature review, focus group interview method and Delphi method, an evaluation index system for risk factors of peripheral venous indwelling catheter failure in adults was established.Results:The recovery rate of the two round were both 100%; the authority coefficient was 0.939, the coordination coefficient was 0.452 and 0.315 respectively ( χ2=607.88, 502.45, P<0.05). Finally an evaluation index system for adult peripheral venous indwelling needle catheter failure risk factors including puncture factors, patient factors, indwelling needle placement factors, indwelling needle maitenance and withdrawal factors and 54 second-level indicators were formed. Conclusions:The construction of adult peripheral venous indwelling needle catheter failure risk factor assessment system is reasonable and comprehensive in content, which provides reference for clinical nurses to evaluate and prevent the failure of adult peripheral venous catheter failure.
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Objective To investigate and compare the effect of two kinds of transparent dressings in the use of fixed intravenous indwelling needle in restless patients in emergency first aid. Methods A total of 160 restless patients who were required to use intravenous indwelling needle were randomly divided into conventional dressing group and 3M dressing group by random digits table method, 80 patients in each group. The medical transparent dressings(Specification:6 cm × 7 cm) were used for the patients of conventional dressing group, and 3M dressings(Specification:6.5 cm×7.0 cm ) for 3M dressing group. The fixity time, number of cases intravenous indwelling needle detached, replaced time of transparent dressing, number of crimping cases were compared. Results For the conventional dressing group, fixity time was (19.67 ± 7.02) h, replaced time was (18.92 ± 6.58) h, 15 detached cases and 24 crimping cases happened. While for the 3M dressing group, fixity time was (41.64±17.79) h, replaced time was (41.11 ± 17.76) h, 4 detached cases and 7 crimping cases happened. The difference was statistically significant(t=-10.27,χ2=7.23, t=-10.48,χ2=11.56, all P<0.05). Conclusions 3M transparent dressing is suggested in fixing intravenous indwelling needle in restless patient in emergency first aid. It can ensure the use of intravenous indwelling needle during the period, effectively prevents the needle from detaching due to its good fixation effect.
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Objective To study the effect of clinically applying catheter fixing device to fix indwelling needle in vein. Methods From July to September 2015, 3 725 patients using ordinary transparent dressing to fix the venous indwelling needle for infusion were assigned in the traditional fixed group, while from November 2015 to January 2016, 3 615 patients applying catheter for fixation and using dressing A type ventilation glue to fix intravenous indwelling needle for infusion were taken as a new fixed group. The detachment rate of venous indwelling needle from tube, rate of again paste film change due to the curl of film edge, the incidence of medical adhesive-related skin injury (MARSI), rate of allergy to medical paste, rate of nurse again fixing the tail of the venous indwelling needle and rate of patient satisfaction in two groups were observed. Results The detachment rate of intravenous indwelling needle from tube [0 vs. 0.75% (28)], rate of again changing paste film [1.55% (56) vs. 11.3% (421)], incidence of MARSI [0 vs. 0.72% (27)], rate of allergy to medical paste [0.06% (2) vs. 0.72% (27)], rate of nurse again fixing venous indwelling needle tail [3.54% (128) vs. 57.5% (2 141)] of new fixed group were obviously less than those of traditional fixed group, the difference being statistical significant (all P < 0.05); the rate of patients' satisfaction of new fixed group was significantly higher than that in traditional fixed group [96.0% (3 576/3 725) vs. 78.6% (2 841/3 615),χ2= 98.135, P = 0.015], the difference being statistically significant (P < 0.05). Conclusion Patients using catheter fixation device to fix venous indwelling needle for infusion can protect the blood fluently flowing through the vascular pathway, avoid inducing the occurrence of complications due to poor fixation, reduce the amount of nurse workload and elevate the rate of patients' satisfaction.
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Objective To explore the optimal concentration of heparin sodium solution, which to seal up intravenous indwelling needle, in patients with Ⅳ thrombocytopenia. Methods A total of 90 patients withⅣthrombocytopenia who required intravenous indwelling needle were randomly divided into three groups which namely A, B and C groups with 30 cases each. A group was sealed up the tube of intravenous indwelling needle with 1 ml heparin sodium solution of 6.25 U/ml, B group with 12.50 U/ml and C group with 25.00 U/ml. The change of the platelet count, plasma prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (Fbg) after extubation were observed in three groups and the incidence of blocking up and retention time were compared among three groups. Results The change of the platelet count, PT, APTT, Fbg were showed no statistical significance among three groups (P>0.05). The incidence of blocking up was 66.7%(22/30) in A group , 43.3%(13/30) in B group and 16.7%(5/30) in C group. They were showed statistical significance (χ2=15.000, P < 0.01). Retention time of tube above or equal to 3 days were observed respectively 13 person (43.3%,13/30) in A group, 21 cases(70.0%, 21/30) in B group, 25 patients(83.3%, 25/30) in C group. All above were showed statistical significance (χ2=11.000, P<0.01). Conclusions Heparin sodium 25.00 U/ml sealing up the tube of intravenous indwelling needle is safe in patient with Ⅳthrombocytopenia, which will reduce the ration of blocking tube and extend the life of tube.
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Objective To investigate the effect of psychological intervention and anti-inflammatory and analgesic ointment on phlebitis caused by intravenous indwelling needle. Methods Selected from December 2015 to April 2017 in our hospital treated with intravenous indwelling needle caused by phlebitis patients 96 cases, were randomly divided into control group and study group, each group of 48 cases.The control group received phlebitis caused by intravenous indwelling needle, and the study group received phlebitis, analgesic plaster and psychological intervention in the treatment of phlebitis caused by intravenous indwelling needle. The clinical efficacy of the two groups was recorded. The data were input into SPSS statistical software and analyzed. Results The study group of intravenous indwelling needle induced phlebitis of patients with clinical total efficiency up to 87.50%, total effective rate of the control group was only 70.83%, (P<0.05) data; after treatment, the scores of SDS and SAS scales in the two groups were significantly lower than before, and the negative effect of the study group was better (P<0.05). Conclusion The application of anti-inflammatory analgesic cream combined with psychological intervention can significantly improve the clinical efficacy of phlebitis caused by intravenous indwelling needle, and is conducive to the protection of their quality of life, physical and mental health.
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Objective To investigate the effect of psychological intervention and anti-inflammatory and analgesic ointment on phlebitis caused by intravenous indwelling needle. Methods Selected from December 2015 to April 2017 in our hospital treated with intravenous indwelling needle caused by phlebitis patients 96 cases, were randomly divided into control group and study group, each group of 48 cases.The control group received phlebitis caused by intravenous indwelling needle, and the study group received phlebitis, analgesic plaster and psychological intervention in the treatment of phlebitis caused by intravenous indwelling needle. The clinical efficacy of the two groups was recorded. The data were input into SPSS statistical software and analyzed. Results The study group of intravenous indwelling needle induced phlebitis of patients with clinical total efficiency up to 87.50%, total effective rate of the control group was only 70.83%, (P<0.05) data; after treatment, the scores of SDS and SAS scales in the two groups were significantly lower than before, and the negative effect of the study group was better (P<0.05). Conclusion The application of anti-inflammatory analgesic cream combined with psychological intervention can significantly improve the clinical efficacy of phlebitis caused by intravenous indwelling needle, and is conducive to the protection of their quality of life, physical and mental health.
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Objective To study the application of the two-paths double U-shaped fixer in clinical intravenous indwelling needle fixation. Methods A total of 420 cases using of intravenous indwelling needle from January to June 2015 were involved and divided into experimental group(210 cases) and control group(210 cases) by random digits table method. The two-paths double U-shaped fixer was applied in experimental group and the control group were used tape by Y type to fix. The incidence of returning-blood, blocking, phlebitis, slippage and the comfort between two groups were observed and compared. Results The incidence of returning-blood, blocking, phlebitis, slippage in experimental group were 6.2%(13/210), 0.5%(1/210), 0 , which were lower than those in control group 48.6%(102/210), 5.7%(12/210), 1.4%(3/210) seperately, the differences were statistically significant (χ2=117.895, P<0.01). The incidence of phlebitis levelⅠ,Ⅱ,ⅢandⅣin experimental group were 3.3%(7/210), 1.4%(3/210), 0.9%(2/210), 0, which were lower than those in control group 11.9%(25/210), 9.0%(19/210), 3.8%(8/210), 2.4%(5/210), the differences were statistically significant(Z=-5.960, P<0.01). The incidence of the comfort level 1, 2, 3 and 4 in experimental group were 92.4%(194/210), 6.2%(13/210), 1.4%(3/210), 0 individually, which were higher than those in control group 36.7%(77/210), 46.7%(98/210), 12.4%(26/210), 4.3%(9/210), the differences were statistical significant (Z=-16.228, P < 0.01). Conclusions Two-paths double U-shaped fixationis is better than Y-shaped tape fixation. To compare the venous indwelling needle fixation, two-paths double U-shaped fixer could fix more effectively and safety. At the same time, it also has advantages in convenient, observation and appearance. It could be widely used in clinical practice.
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Objective To improve the fixation method of indwelling needle inserted in the tail vein in rats to keep the inserted needle for a longer indwelling time .Methods One hundred healthy Wistar rats ( age 5~6 months, male:female=1:1) were randomly divided into two groups: the experimental group and the control group .Rats in both groups received the same tail vein indwelling needle puncture and cannulation .The control group got the traditional fixation , namely fixed by sticking with 3M transparent dressing paste .The experimental group received in addition to the traditional fixation, a 0.1 mm-thick aluminum tube placed outside the needle fixation site .The indwelling time in the rats were recorded and analyzed .Results The indwelling time was (166.86 ±9.03) h and (20.24 ±5.04) h in the experimental and control groups, respectively (t =68.546, P<0.01).Conclusions Our improved method is safe and reliable.It can prolong the indwelling time of the punctured intravenous indwelling needle , and provides a useful rat model in studies on the complications of intravenous indwelling needle kept for a longer time .
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Objective To discuss the advantages of combined use of intravenous indwelling needle and infusion connector joint.Methods 120 cases of children in our hospital receiving chemotherapy through intravenous infusion were randomized into the control group and the experimental group with 60 cases in each group.The control group used heparin cap,after each infusion was completed,with 12.SU/ml 3～5ml of heparin saline pulse-type sealing.The experimental group adopted infusion connector joint,after the infusion completed,3～5 ml normal saline was injected into the joint to flush the blessing sealed tube.The complications rate was calculated in two groups.Results The experimental group and the control group showed differences in the incidence of complications and the patients' approval to nurses.Conclusions Combination of intravenous indwelling needle and infusion connector joint can reduce the complications significantly,and improve patients' approval to nurses.