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@#Introduction: Insertion of Peripheral intravenous catheter (PIVC) is a common invasive procedure performed on patients that may contribute to several complications. Nurses are required to have adequate knowledge and practice to ensure the successful of the procedure. The objective of this study was to determine the knowledge and practice of nurses towards PIVC insertion procedures. Methods: A descriptive cross-sectional study design was conducted at Universiti Kebangsaan Malaysia Medical Centre. A total of seventy- seven nurses working in the emergency department, obstetrics & gynecology patient admission centre, daycare oncology were participated in this study. The data was gathered using a modified questionnaire and standard PIVC insertion guidelines. Results: 21 (27.3%) nurses had high knowledge and 56 (72.7%) had low knowledge of PIVC insertion (M=7.77, SD=1.87). All 77 (100%) nurses performed insertion of PIVC according to the standard of practice (M=23.16, SD=1.51). A positive correlation between age and knowledge (rho=0.123) but a negative correlation towards practice (rho=-0.413). A positive correlation between working experience and knowledge (rho=0.094) but a negative correlation towards practice (rho=-0.047). There was a positive correlation between nurses’ knowledge and practice (rho=0.038). Conclusion: Nurses with good knowledge of PIVC insertion performed better as they were aware of the negative consequences of the procedure if conducted incorrectly. Knowledgeable and competent nurses are essential to ensure the quality of nursing care and safe practice towards patients. Future studies with larger samples of nurses involved in more hospitals in Malaysia are recommended.
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@#Intravenous (IV) infusion of medical fluid is a very common procedure used as part of medical procedure treatment. It is also the best alternative medical administration route when medical administration through orally is impossible. The most common use of VAD is the short Peripheral IV Catheter (PIVC) or recognized as IV Cannula. In spite of that, even with experience used of PIVC in medical practice nowadays the rate of IV access failure is very high which is up to 69%. Intensive research studies shows the dislodgement case is one of the major contributions of PIVC failure. For some reason only a fewer cases are reported to the administration. This article seeks the awareness and risk factor regarding to the prevailing IV access failure using the PIVC. This manuscript reviewed the statistical data of PIVC dislodgement, significant of dislodgement, dislodgment cases among pediatric, medical staff factor related to PIVC dislodgement and alternative of securement device. This manuscript also discussed the needs of new securement device in order to reduce the percentage of PIVC dislodgement from occurs.
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Background: Open peripheral intravenous (IV) catheters have been routinely used in neonates. Closed catheters have resulted in a longer indwelling time and reduction in catheter related complications such as phlebitis in adults. However, there is paucity of data in neonates.Methods: We conducted this pilot study in a pre-post study design. Open catheters were used in the first phase and closed catheters in the second phase. Hundred babies requiring intravenous fluid therapy for at least 24 hours in this neonatal intensive care unit were included in each group. Indwelling time and the complications leading to removal of the catheter were compared between the two groups.Results: Both groups were comparable in terms of gestational age, day of life, site of cannulation, nature of intravenous fluid and drugs administered. In the open catheter group, there was significant increase in use of inotropes (38% vs 22%; p=0.014) and blood products (16% vs 5%; p=0.011). The mean indwelling time (hours) was significantly greater in closed catheter group compared to open catheter group (47.1'19.4 vs 38.04'17.9; p <0.008). Inotrope use was found to decrease the indwelling time. There was an increase in indwelling time by 8.2 (SE 2.67) hours even after adjusting for use of inotropes. The incidence of catheter related complications was similar in both groups.Conclusions: There is a marginal but statistically significant increase in indwelling time when closed peripheral IV catheters are used in neonates. However, our results would be more meaningful if replicated in a larger randomized controlled trial.
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Objective To investigate the effect of Site-Rite 5 vascular ultrasound on puncturing of grade Ⅱ and Ⅲ veins.Methods Purposive sampling was used and 59 patients with grade Ⅱ and iⅢ veins to receive peripheral intravenous catheteration (PIV) were divided into observation group and control group according to the different wards:30 patients in the observation group and 29 in the control group.The control group received indwelling PIV by routine method and in the observation group,the patients' veins were assessed by Site-Rite 5 ultrasound-guided instrument and marked,followed by puncturing with PIV.The two groups were compared in terms of one-time success rate and incidence of complications.Results The one-time success rate of the observation group was significantly higher than that of the control group.There was no significant difference in the incidence of complications between the two groups (P ＞0.05).Conclusions By the Site-Rite 5 ultrasound-guided instrument,the invisible veins become visible.It is beneficial to improve the success rate of puncturing.
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Peripheral Intravenous Catheters (PIC) are widely used. Nurses are required to possess appropriate knowledge and practice. The present study aimed to determine nurses' knowledge and practice towards care of PIC. A cross-sectional descriptive study was conducted and 84 respondents participated in the study. A 26-item questionnaire comprising 11 items on knowledge and 15 items related to nursing practice was adapted and modified. The findings reported higher mean score from specialty unit respondents, with knowledge (M = 49.19, SD = 3.44) and practice (M = 66.38, SD = 5.15), compared to medical surgical wards with knowledge (M = 46.25, SD = 4.68) and practice (M = 63.17, SD = 4.63) towards the care of PIC, which was significant (p value = 0.010 and p value = 0.009, respectively). The study indicated a higher mean score of charge nurse respondents as compared with registered nurse with knowledge (M = 49.68, SD = 3.23); (M = 46.20, SD = 4.62) and practice (M = 67.11, SD = 4.84); (M = 63.06, SD = 4.61), which was significant (p value = 0.003 and p value = 0.001, respectively). There were no significant differences between respondents’ education qualification towards care of PIC with p > 0.05. However, the findings reported that respondents who possessed Bachelor of Nursing were deemed to score slightly higher in their knowledge and practice towards the care of PIC. In conclusion, the specialty unit and charge nurse respondents were deemed to possess better knowledge and practice towards the care of PIC in the hospital.
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FlebitisRESUMEN
ObjectiveTo evaluate the clinical efficacy of intravenous catheter in combination with ultraviolet radiation for postherpetic neuralgia (PHN).Methods96 patients with PHN were randonly divided into three groups.Intravenous catheter plus UVB radiation was given in the test group(32 patients).Intravenous catheter or UVB radiation was only given in two control groups (32 patients/group), respectively.ResultsThe total effective rate in the test group was 96.88％ (31/32) and the average onset time was 1.55 days.However,the total effective rate in two control groups was 81.25％ (26/32) and 68.75％ (22/32) ,and the average onset time was 2.48 days and 7.41days.There was a statistical difference observed in curative rate (x2 = 5.33,42.42, P ＜ 0.05 or P ＜ 0.01), the total effective rate(x2 =4.59,8.89,P＜0.05 or P＜0.01) and the average onset time(t =22.96,11.96,all P＜0.01)between the test group and two control groups.Moreove,there was also a statistical difference observed in curative rate (x2 = 22.44, P ＜ 0.001) and the average onset time (t = 29.30, P ＜ 0.01) between two control groups.ConclusionIntravenous catheter in combination with UVB radiation was much better than intravenous catheter or UVB radiation only in the treatment of PHN.
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Objective To observe the relationship between degree of venous injury and the indwelling time by injection of chemotherapy drugs with intravenous catheter system. Methods Totally 43 New Zealand rabbits were selected as the study sample. Among them, three rabbits were chosen by lot as a blank control, the others were evenly divided into two groups randomly. The veins at the edges of the two ears were taken out as the tested blood vessels for the infusion with intravenous catheter system. The two groups were injected respectively with physiological saline and chemotherapy drugs once daily, and then blocked with heparin salt water. After intraperitoneal anaesthesia, pathological sections were prepared by taking live samples from the ear vein where intravenous catheter system puncturing on the 2nd, 4th, 6th,8th and 10th day of transfusion. And inflammation and thrombosis in the vein had been observed under the light microscope. Results In the same indwelling time, the inflammatory response of the two groups was compared: no difference on the 2nd day; difference was seen on the 4th、6th and 8th day; but again no difference on the 10th day. Thrombosis compared: no difference on the 2nd, 4th day, but difference was seen on the 6th, 8th and 10th day. Conclusions Chemotherapy drugs has a strong irritant on blood vessels.The indwelling time should not be too long, generally advisable 2 days,even if no abnormal response is observed locally by the naked eye.
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Objective To explore the relation between sealed tube method and retention time of intravenous catheter system . Methods Adopt direct injection seal-tube method, saline injection seal-tube method and heparin liquid seal-tube method with common intravenous catheter were adopted the intravenous catheter's retention time and incidence of phlebitis were observed. Results The retention time in direct injection seal-tube group and saline injec-tion seal-tube group respectively prolonged of 25.7% and 19. 3% compared with heparin liquid seal-tube group.There was significant difference (P < 0. 01 or P < 0. 05) through statistical analysis. But there was no significant differ-ence(P 0. 05) between direct injection seal-tube group and saline injection seal-tube group in retention time. Theincidence of phlebitis in both direct injection seal-tubo group and saline injection seal-tube group were below to the heparin liquid seal-tube group. There was significant difference(P 0. 05) in the three groups. But there was no sig-nificant difference(P 0. 05) between direct injection seal-tube group and saline injection seal-tube group in the inci-dence of phlebitis. Conclusion Direct injection seal-tube method and saline injection seal-tube method can signifi-cantly extend intravenous catheter's retention time and reduce the incidence of phlebitis.
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Purpose : The purpose of this study was to obtain epidemiologic data and overall risk of complications of short term peripheral intravenous catheters. METHODS: The data was collected prospectively from August 19 to september 13, 2002. The subjects of this study were 350 adult patients hospitalized to the internal medicine a surgical general ward. Catheter sites were inspected daily from insertion to removal by infection control nurses, and characteristics of patients and catheters were recorded. Phlebitis was defined as one of the followings along the course of the vein: erythema, warmth. swelling or tenderness. RESULTS: Overall incidence of the phlebitis associated with short-term catheter was 23.7%. Catheters were removed when routine catheter replacement (every 72 hours) was occurred in 24.9%, phlebitis 23.7%. discharge of patients 13.1%, change of heparin cap 9.7%, others 28.6%. There were no significant differences in the incidence of the phlebitis by sex, age, the type of dressing, the duration of catheter placement insertion site, the type of hospitalized ward' and the size of cannula. The incidence of phlebitis was the highest (36.1%) within 48-72 hours after insertion. There was significant difference in the incidence of phlebitis according to the types of infusate. 75 of 83 phlebitis cases (90.4%) were received chemical infusates. Especially glucose/aminoacid, TPN and intralipose were attributed to major risk factor of phlebitis associated with short-term catheter (P<0.05). CONCLUSION: The incidence rate of phlebitis associated with short-term catheter was 23.7%. In this study, the type of infusate was the significant risk. factor related to phlebitis. Consequently, in order to prevent and detect the phlebitis associated with short-term catheter early, a consistent, organized assessment and evaluation of the above factors during the intravenous therapy is needed.
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Adulto , Humanos , Vendajes , Catéteres , Estudios Epidemiológicos , Eritema , Heparina , Incidencia , Control de Infecciones , Medicina Interna , Corea (Geográfico) , Habitaciones de Pacientes , Flebitis , Estudios Prospectivos , Factores de Riesgo , Seúl , VenasRESUMEN
BACKGROUND: Intravenous catheter-related complication among the hospitalized patients has been increasing recently in Korea, since many hospitals has tried to save expenses by replacing the foreign-made catheter with domestic-made intravenous catheter. We studied the incidence rate of catheter-related complication and compared the incidence of catheter-related complication between domestic-made and foreign-made ones. We also studied to elucidate whether the morphologic characteristics of the intravenous catheter will effect the incidence of catheter-related complication. METHOD: From July 1 to Sept 30, 1998, we surveyed the incidence rate of intravenous catheter-related complication among the hospitalized patients in the wards of Medicine. Surgery, Obstetric, and Neonatal Intensive Care Unit in Guro Hospital, Korea University Medical center. We also compared the incidence of complication between domestic-made catheter (catheter A) and foreign-made catheter (catheter B) of three different gages (24G, 22G and 18G). The morphologic characteristics of intravenous catheters has been studied by electron microscopy. RESULT: Complication associated with use of intravenous catheter had been occurred 263 out of 459 cases (57.3%), among those cases, non-infectious complication and infectious complication were 173 cases (37.7%) and 90 cases (19.6%), respectively. Totally, catheter A group showed higher complication than catheter B group [62.0% (160/258) vs 51.2% (103/201), P=.021]. Analysis on the incidence rate of complication according to the products did not show significant differences in the noninfectious complication in every gage groups. However the infectious complication occurred higher in the domestic-made catheter A group than among the foreign-made catheter B group [(24G: 6% vs 0%, P=.026), (22G: 25.6% vs 9.6%, P=.001), (18G: 36.8% vs 13.4%, P=.002)]. Duration of catheter life did not show the difference between catheter A group and catheter B group [48.5hrs vs 50.3hrs, P=.474]. The analysis on risk factors for complication showed that catheter A group is highly related (odd ratio 1.85). The morphologic analysis of the catheter by using electron microscopy showed that the angles in the tip of the introducing needle of catheter Aand catheter Bare 60degrees and 45degrees , respectively, and the bevel between introducing needle and catheter sheath are 50degrees and 27degrees, respectively. CONCLUSION: There was a higher incidence rate of complication related to domestic-made catheter usage, which might influence increasing the period of the hospitalization and the expenses due to the complication. The study of cost effectiveness analysis needs to be performed regarding intravenous catheter-related complication. Morphologically, catheter A showed more blunt angle in the tip and transition area of the introducing needle than the angle of catheter B, which is considered to influence the higher complication incidence. It needs to improve the quality of domestic-made intravenous catheter.