Knowledge and Practice Of Peripheral Intravenous Catheter Among Nurses in a Teaching Hospital in Malaysia: Universiti Kebangsaan Malaysia Medical Centre

@#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.

Programa de prevención de las bacteriemias asociadas a catéteres venosos centrales / Program for prevention of central venous catheter-related bacteremia

Introducción: Las infecciones son las complicaciones más importantes asociadas al uso de los Catéteres Venosos Centrales (CVC), representan un riesgo 20 veces mayor de bacteriemias que los catéteres venosos periféricos. El objetivo de este estudio fue evaluar el efecto de la implementación de un paquete de medidas o "bundle" en las infecciones asociadas a catéteres venosos centrales (BACT- CVC) en la Unidad de Cuidados Intensivos del Hospital Garrahan (UCI). Métodos: El Programa de Intervención para disminuir las bacteriemias asociadas a catéteres venosos centrales requirió de la aplicación de cuatro paquetes de medidas y un subprograma para aumentar la adherencia a la higiene de manos. Se aplicó en todas las UCI, pero en el presente estudio se presenta como modelo de referencia el que se llevó a cabo en una de ellas. Período del estudio: se compararon 2 períodos: basal (1º Agosto de 2008 - 31 de Diciembre de 2009) y intervención (1º de Enero 2010 al 31 de Diciembre de 2011). La tasa de BACT - CVC se calculó en concordancia con los protocolos utilizados por el sistema NHSN - CDC de los Estados Unidos y el sistema nacional VIHDA. La base de datos utilizada para el estudio fue el software provisto por el programa VIHDA. Se compararon las tasas de BACT - CVC en el período previo y posterior a las intervenciones realizadas. Para el análisis estadístico se utilizó el programa EPIINFO. Se consideró estadísticamente significativo un valor de p < 0.05. Resultados: en el primer período (Agosto 2008 - Diciembre 2009) se produjeron un total de 44 BACT - CVC, con una tasa promedio de 9.64 BACT-CVC por 1000 días-catéter versus 17 BACT - CVC, tasa promedio de 4.41 BACT-CVC por 1000 días-catéter en el período en que se desarrolla el programa de intervención. Esta disminución resulta estadísticamente significativa (Chi cuadrado; valor P= 0,0048; RR 0,46; IC 95%: 0,26 - 0,80). Conclusiones: La aplicación de los combos y el subprograma para mejorar la adherencia a la higiene de manos según orientación de la OMS y aplicando Estrategias Multimodales, resultaron en una mejora significativa en la tasa de BACT- CVC (AU)

Introduction: Infections are the main complication associated with the use of central venous catheters (CVC), accounting for an infection risk about 20 times that of peripheral venous catheters. The aim of this study was to assess the effect of the implementation of sets of measures or "bundle" for the prevention of CVC-associated bacteremia (CVC-BACT) in the ICU. Methods: The intervention program for the reduction of CVC-BACT consisted of four sets of measures and a sub-program to increase adherence to hand hygiene. Bundle use was started in all PICUs, however, in this study implementation of the program in one of them was used as a reference model. Study period: Two periods were compared: Baseline (August 1, 2008 ­ December 31, 2009) and intervention (January 1, 2010 ­ December 31, 2011). The CVC-BACT rate was calculated according to the NHSN-CDC protocols of the United States and the Argentine VIHDA system. For the data base of the study software provided by the VIHDA program was used. CVC-BACT rates before and after the intervention period were calculated. For statistical analysis the EPIINFO program was used. A p < 0.05 was considered significant. Results: In the first period (August 2008 - December 2009) 44 CVC-BACT occurred, with a mean CVC-BACT rate of 9.64 per 1000 catheter days versus 17 CVC-BACT, mean CVC-BACT rate of 4.41 per 1000 catheter days, in the intervention period. This decrease was statistically significant (Chi square 7.94; p = 0.0048; RR 0.46; 95% CI: 0.26 ­ 0.80). Conclusions: Bundle use and the subprogram for better adherence to hand hygiene, according to WHO guidelines and applying multimodal strategies, resulted in a significantly lower CVC-BACT rate (AU)

Resultados do emprego da solução salina em cateteres venosos periféricos: fundamentando o cuidado de enfermagem / Results from the use of saline solution in peripheral venous catheters: underlying the nursing care

Trata-se de uma pesquisa sobre a temática dos cuidados de enfermagem com o cateterismo venoso periférico (CVP), em pacientes que estejam recebendo infusões intermitentes de solução salina para sua manutenção. O problema que se pesquisou consistiu em saber qual o resultado que se obtém na manutenção da permeabilidade do cateter venoso periférico quando irrigado com solução salina? Os objetivos foram: a) Criar um guia para o emprego de solução salina 0,9% em cateteres venosos periféricos baseado nas recomendações da Infusion Nurses Society (INS), b) Treinar a equipe de enfermagem no uso do guia de salinização de CVP e c) Analisar os resultados obtidos com o emprego do guia de salinização para CVP. A base teórica do estudo centrou-se no referencial da INS. Metodologia: Foi um estudo com desenho clínico-epidemiológico, desenvolvido na modalidade prospectiva, com modelo de intervenção, delineamento quase-experimental e grupo único, realizado no Hospital Pró-Cardíaco. A população foi constituída de pacientes que necessitaram do uso do CVP com administrações intravenosas intermitentes. Este estudo atendeu a Resolução 196/96. A coleta dos dados prospectivos foi feita através do preenchimento do formulário de monitoramento, com a avaliação diária dos acessos venosos dos pacientes incluídos no estudo, durante o período de cinco meses. Foi considerada a incidência baseando-se no n representado pelo número de punções periféricas e não pelo número de pacientes. Resultados: O estudo se pautou em 58 pacientes, correspondendo a 79 punções para análise da eficácia da solução salina. A população ficou caracterizada como idosa, com média de 71 anos, prevalecendo o sexo masculino com 55.17%, dos quais 62.06% eram cardiopatas e 60.34% usavam anticoagulantes...

This research is over the thematic of nursing care with peripheral venous catheters (PVC) in patients who are receiving intermittent infusion of saline solution for his/her own maintenance. The researched problem consisted in knowing which is the result obtained in the maintenance of the permeability of the peripheral venous catheters when irrigating with saline solution? The goals were: a) to create a guide to the use of the saline solution 0,9% in peripheral venous catheters based on recommendations from Infusion Nurses Society (INS), b) to train a team of nurses in the use of the guide of the use of saline solution for peripheral venous catheters and c) to analyze the obtained results with the use of the guide of saline solution for peripheral venous catheters. The theoretical basis of this study focused on the INS reference. Methodology: The study was made from a clinical-epidemiological design, developed in a prospective way, with the intervention model, quasi-experimental delineating and one group, accomplished in the Pró-cardíaco Hospital. The population was made of patients who needed the use of peripheral venous catheters with intermittent intra-venous managing. This study was based on the 196/6 resolution. The prospective data collection was made during the period of 5 months through the filling of a surveillance form, with the daily evaluation of venous access of the patients in the study. The incidence was considered based on the n represented by the number of peripheral punctures and not by the number of patients. Results: The study was made around 58 patients corresponding to 79 punctures for the analysis of efficacy of the saline solution.The population was characterized as elderly, with mean age of 71, prevalence of males with 55.17%, from whom 62.06% were with cardiopathy and 60.34% used anti-coagulant...