ABSTRACT
Objective@#To evaluate the safety of clinically-indicated replacement of peripheral intravenous catheters (PIVCs) in old adults.@*Methods@#Total of 1 627 patients with peripheral intravenous catheters in emergency wards at a tertiary hospital in shanghai were recruited. Patients were randomly divided into an experimental group (817 cases) and control group (810 cases) by random digits tale method. PIVCs in the experiment were replaced only when clinical indications appeared, while PIVCs in the control group were routinely changed every 72-96 hours. Indwelling time, complications associated with PIVCs and nurse compliance were compared after indwelling peripheral intravenous catheters.@*Results@#PIVC indwelling time was (3.43±1.36) days in the experimental group, and (3.18±1.16) days in the control group ,there was significant difference between two groups (t value was 4.07, P<0.05). The incidence of phlebitis, occlusion, infiltration, and accidental removal in experimental group was 11.26% (92/817), 17.97% (146/817), 10.77% (88/817), 3.91% (32/817), while in the control group 9.88% (80/810), 15.06% (122/810), 11.23% (91/810), 3.70% (30/810). The two groups showed no statistically difference in catheter phlebitis, occlusion, infiltration, and accidental removal (χ2 values were 0.82, 2.33, 0.09, 0.05, P>0.05). The severity of phlebitis in the experiment group was higher than that in the control group, and there was significant difference between two groups (χ2 value was 20.99, P<0.05). Nurse compliance achieved in the experimental group 100.00% (817/817) was higher than that in the control group 87.65% (710/810), which showed statistically difference (χ2 value was 107.47, P<0.05).@*Conclusion@#Indwelling time in the clinically- indicated replacement group was longer than that of the routine replacement group. Peripheral intravenous catheters in old adults can be remove as clinically-indicated with a close monitoring of complications.
ABSTRACT
Objective@#To investigate the current status and influencing factors of basis of the replacement of short peripheral intravenous catheters for clinical nurses and explore the obstruction of the latest guide promoted in practice.@*Methods@#The qualitative research method was adopted, and semistructured interviews were used to interview 11 clinical nurses. Data were analyzed by the method of category analysis.@*Results@#Although the clinical nurses mainly used the national standards to do practical operation, they preferred to carry out catheter replacement according to clinical indications. The difference between the latest guide and the national standards was the main obstruction in the practical promotion of the latest guide.@*Conclusions@#The removal of short peripheral intravenous catheters according to clinical indications is more suitable for clinical practice. Further improving the standards of intravenous therapy in China has become a fundamental measure to solve the contradictions of work of clinical nurses, improve patients′ medical experience and save medical resources.
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Objective To evaluate the effects of blood withdrawal from peripheral intravenous catheters (PIC) on blood samples via meta-analysis.Methods We performed a systematic search in Cochrane Library,PubMed,EBSCO,CINAHL,Embase,CMBdisc (China Biology Medicine disc),Wan Fang Data,VIP (China Science and Technology Journal Database),CNKI (China National Knowledge Infrastructure)to collect randomized controlled trails (RCTs)about the effects of blood withdrawal from peripheral intravenous catheters.The quality of RCTs was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted for eligible RCTs.Results Totally 22 studies were retrieved and 7554 blood samples were included.Results of meta-analysis showed as compared with standard blood drawn by direct venipuncture (DVP),there was no significant risk of hemolysis rates of blood samples collected from PVC [random effect RR =2.01,95％ CI (1.01,4.00),P=0.05];with certain procedures,results of laboratory tests of blood samples withdrawal from PIC had little impacts on red blood cell count(RBC),white blood cell count(WBC),platelet count (PLT),fasting blood-glucose(FBG)and serum levels of sodium,potassium,calcium,chlorine,and the differences had no statistical significance (P＞0.05).Conclusion Blood samples withdrawal from PIC will not increase hemolysis if sampling after infusion has been stopped for 2～3 min and 2～5 ml blood is discharged,which are reliable for blood routine and biochemical tests.After a comprehensive consideration,the technique of blood withdrawal from a PIC could be used interchangeably from DVP.
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Objective To investigate the clinical effectiveness of peripherally inserted central catheters(PICC) and peripheral intravenous catheters(PIV) in tumor chemotherapy. Methods A total of 180 patients with intravenous chemotherapy were randomly divided into two groups. 108 patients in the PICC group, 72 patients in the PIV group. The holding time and complications were observed and compared. Results The rate of complication in the PICC group were much lower than the PIV group, however was much longer than the PIV group in holding time. But there was no statistical difference in the positive culture rate of bacteria of two groups. Conclusions It is very safe to use PICC which can reduce the rate of complication of catheters and venipuncture times and is worthy of spreading in practice.