ABSTRACT
Introduction: Antineoplasic chemotherapy in intravenous infusion is one of the most common therapeutic modalities in cancer patients. The vast majority of antineoplasic drugs have an Osmolarity >900 mOsm/l, so its administration must be done through central venous routes. However, the channelling of central routes is limited to patients with difficulty in peripheral venous approach or long-term treatments. Objective(s): Describe the vascular accesses used at the University Hospital of La Ribera for the administration of antineoplastic drugs, assess the adequacy of the same and determine if the type of vascular access used varied during the COVID-19 pandemic. Methodology: A quantitative, observational and analytical cross-sectional study of the vascular accesses used in the administration of antineoplasic therapy in cancer day hospital was carried out. Data collection was carried out through direct observation and consultation of the medical history. The pre-pandemic period was executed from 20 to 21/1/2020(n=125), the pandemic sample from 8 to 12/2/21(n=121). Result(s): Although 70% of the drugs administered had the capacity for tissue aggression, the peripheral venous route was established in 69.9% of cases, the forearm being the most frequent anatomical location (n=102) and the peripheral venous catheter the most commonly used device (n=172). The expected duration of treatment was medium-term in 74.8% of patients. The use of central venous routes during the pandemic increased by 30.7%,(p=0.017), being the subcutaneous venous reservoir the one with the highest representation(RVSC 75.5 %, IPCC 24.5 %). Conclusion(s): Short peripheral venous catheter was the most used device in the administration of chemotherapy in oncology HDD of the UHLR, even administering drugs with high tissue aggression and establishing a medium duration of treatment, being this an area of improvement in the care of cancer patients. During the pandemic, the use of central routes increased in the administration of antineoplasic treatment on an outpatient basis.
ABSTRACT
Introduction: INCATIV is a research program carried out by nurses on 34 hospitals of the Region of Valencia (Spain). This program measures vascular access quality on patients of these hospitals via cross-sections. The objective of the study is to evaluate the influence of COVID-19 pandemic in the registers of the vascular accesses' quality program. Method(s): Quantitative observational, analytical, and retrospective study of two cross-sections. First cross-section was developed before pandemic (C10: 02-2020) and second cross-section during pandemic (C11: 05-2020). Data was obtained from INCATIV's platform. Result(s): Among 34 participant hospitals in INCATIV Program, there was a 100% of participation at C10, collecting 7647 registers of all hospital units included at the program. 4820 vascular accesses were evaluated. Only a 1.22% of them presented signs of phlebitis. 92% of the vascular accesses had the right dressing. At C11, there was a 50% of participation. 3234 registers were collected. Phlebitis rate remains at 1.15%. The use of correct dressing reached at 92% too. Discussion and conclusion: Data indicate a strong decrease in the number of participating hospitals as on the number of registers of this quality program focused on intravenous therapy, confirming the existence of changes in the trend of the registers, in the absence or presence of pandemic moments. On the other hand, it is observed that there are no statistically significant differences related to the quality of the vascular accesses, showing that two main indicators measured, included at INCATIV bundle, such as type of dressing and signs of phlebitis, remain constant despite being measured at two different pandemic moments. Further studies are necessary about how vascular accesses nursing care has changed only in COVID-19 patients.