ABSTRACT
ABSTRACT Objectives: To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Method: Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. Results: The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. Final considerations: The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools.
RESUMEN Objetivos: Identificar las dificultades del personal de enfermería en utilizar tecnologías durante la terapia intravenosa (TIV) y discutir las dificultades encontradas bajo el punto de vista de la seguridad del paciente. Método: estudio cualitativo, de tipo descriptivo, en el cual se empleó entrevista semiestructurada para la recolección de los datos y los analizó por el programa Alceste. Resultados: La dificultad de énfasis cognitiva y técnica más frecuente fue la ausencia de capacitación para utilizar la tecnología; y la de énfasis administrativa fue la ausencia de recursos materiales y humanos. El recurso tecnológico que más contribuye para garantizar la seguridad del paciente fue las bombas de infusión y su correcto empleo. Consideraciones finales: El personal de enfermería relató que la ausencia de capacitación es la dificultad que más enfrentan, y que les va a influir en la seguridad del paciente y del profesional al emplear las tecnologías en la TIV. Las capacitaciones son esenciales para el desarrollo de las técnicas, consideradas las herramientas de hacer enfermería.
RESUMO Objetivos: Identificar quais são as dificuldades da equipe de Enfermagem no manejo das tecnologias durante a terapia intravenosa (TIV) e discutir as dificuldades identificadas sob a perspectiva da segurança do paciente. Método: abordagem qualitativa, do tipo descritivo com dados coletados por entrevista semiestruturada e analisados pelo programa Alceste. Resultados: A maior dificuldade de ênfase cognitiva e técnica foi a falta de treinamento; e de ênfase administrativa, foi a falta de recursos materiais e humanos. As bombas de infusão e sua utilização adequada foram destacadas como o recurso tecnológico que mais contribuiu para a segurança do paciente. Considerações finais: A falta de treinamento é apresentada como a maior dificuldade dos profissionais de Enfermagem e permeia as questões de segurança do paciente e do profissional ao utilizar as tecnologias duras na TIV. O treinamento é imprescindível para o desenvolvimento das técnicas, consideradas como ferramentas do fazer da Enfermagem.
Subject(s)
Humans , Infusions, Intravenous/instrumentation , Infusions, Intravenous/standards , Patient Safety/standards , Nursing, Team/standards , Teaching/standards , Chi-Square Distribution , Clinical Competence/standards , Qualitative Research , Hospitals, University/organization & administration , Intensive Care Units/organization & administration , Nurses/standardsABSTRACT
OBJECTIVE: To evaluate the accuracy of ACCUFLOW an infusion rate monitor as compared to manual reading in pediatric surgical patients. METHODS: An observational study in 47 pediatric patients undergoing elective surgical procedures and needing an intravenous fluid with expected duration of infusion of at least one hour. The infusion rate was adjusted to the required flow rate with the help of the display on the ACCUFLOW. The flow rate as indicated by the ACCUFLOW display was checked every 15 minutes till the end of one hour. A simultaneous record of manual readings was also made. RESULTS: A total of 470 observations were made over the one hour observation period. The infusion rate as observed on the LCD display of the ACCUFLOW compared well with manual reading. A Bland Altman analysis showed the bias between the readings with the two methods to be very small and that there is no significant difference between the methods over the drop rate of 61-74 drops/min. In addition an alarm was heard in 9 cases. The alarm was mainly because of no flow or excess flow (3 cases each). Other causes for the alarm included slow flow, faulty i.v. lines showing fluctuations in flow rate and drip chamber not placed properly (1 patient each). CONCLUSION: ACCUFLOW is a low cost device that can be used to adjust and monitor the infusion flow rate. The alarm would alert the nursing staff when there is deviation from the preset rate of infusion. ACCUFLOW could thus be an attractive option for infusion rate monitoring in developing countries with limited healthcare resources and skewed patient nurse ratios. However applicability to infants and younger children and for longer infusions needs to be determined.
Subject(s)
Child , Child, Preschool , Cohort Studies , Equipment Design , Equipment Safety , Female , Humans , Infant , Infusions, Intravenous/instrumentation , Male , Medication Errors/prevention & control , Monitoring, Intraoperative/instrumentation , Risk Assessment , Sensitivity and Specificity , Elective Surgical ProceduresSubject(s)
Bacteremia/microbiology , Colony Count, Microbial , Drug Contamination/prevention & control , Filtration/instrumentation , Fluid Therapy/instrumentation , Infusions, Intravenous/instrumentation , Materials Testing , Pseudomonas/isolation & purification , Staphylococcus aureus/isolation & purificationSubject(s)
Aortic Valve Insufficiency/complications , Catheterization/adverse effects , Child , Dextrocardia/surgery , Equipment Contamination , Female , Heart Valve Prosthesis Implantation , Humans , Infusions, Intravenous/instrumentation , Mycoses/diagnosis , Pacemaker, Artificial , Rhodotorula/isolation & purification , Situs Inversus/surgeryABSTRACT
Presentamos nuestras experiencias acumuladas desde enero de 1988 hasta marzo de 1991 en el Hospital ABC con el manejo de 151 pacientes (54.3 por ciento mujeres y 45.69 por ciento varones), que requirieron de 153 accesos vasculares temporales con catéteres de hule siliconizado (Hickman 9.6 Fr. 71.2 por ciento, Broviac 6.6 Fr. 24.83 por ciento y Hickman 9.0 Fr. 3.9 por ciento). Su indicación fue quimioterapia en el 76.15 por ciento, antibioticoterapia en el 19.20 por ciento y nutrición parenteral en el 4.63 por ciento. Se colocaron con técnica percutánea (97 por ciento) o por venodisección (2.66 por ciento). El tiempo de seguimiento fue de un día a 20 meses (promedio 4.82 meses).Morbilidad: complicaciones intraoperatorias 3.26 por ciento, postoperatorias 15.83 por ciento. Mortalidad: operatoria 0.66 por ciento, no operatoria 32.45 por ciento. El empleo se accesos vasculares temporales con catéteres de hule siliconizado fue de gran ayuda en el manejo de estos enfermos.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Administration, Cutaneous , Catheterization, Central Venous/statistics & numerical data , Drug Therapy , Infusions, Intravenous/instrumentation , Infusions, Parenteral/instrumentation , Jugular Veins/surgery , Parenteral Nutrition/instrumentation , Punctures/statistics & numerical data , Subclavian Vein/surgery , Vena Cava, Inferior/surgery , Vena Cava, Superior/surgery , BloodlettingABSTRACT
As autoras apresentam um método de ensino por elas testado, implantado e atualmente utilizado nas aulas práticas dos procedimentos de punçäo venosa, ministraçäo de medicamentos por via endovenosa e infusäo intravenosa, para alunos das disciplinas Introduçäo à Enfermagem e Introduçäo à Prática Hospitalar dos cursos de Graduaçäo em Enfermagem e Obstetrícia e de Medicina, respectivamente, na Universidade Federal de Mato Grosso. Descrevem a instalaçäo do sistema que simula uma veia e relacionam o material para sua construçäo. Destacam a importância do laboratório de simulaçäo do procedimento e concluem que a utilizaçäo desse sistema tem sido uma excelente forma para o ensino dos mesmos.