Adaptation of midline and mini-midline catheters for patients with COVID-19

Objective: to analyse the time of permanence andmain causes for removal of midline (20 cm) and mini-midline (10 cm) catheters in hospitalized patients, and to study the differences in patients with COVID-19. Method: a descriptive, cross-sectional, retrospective study conducted with data from clinical records in the Hospital Universitario Vall d´Hebron (Barcelona, Spain). The study includedcatheters insertedby the Infusion andVascular Access Nursing (IVAN) Team in patients hospitalized during 2020. Results: the study included 357 catheters in 305 patients (28.9% with COVID-19). The latter presented a higher rate of obesity (21.6% vs. 9.2%;p= 0.003). The median duration of catheters inserted was 11-12 days, without any difference by type of catheter or having COVID-19 (p= 0.88). The main cause for removal in both groups was the end of the treatment, and it was higher in patients without COVID-19 (65.7% vs. 53.1%;p= 0.031), followedby exitus in patients withCOVID-19 (22.9% vs. 8.9%;p= 0.001), and catheter occlusion in the rest (17.3% vs. 8.33%;p= 0.035). There were n= 4 cases of catheter infection and n= 31 suspected cases, without difference by diagnosis or type of catheter. There was no variation in the cause for removal according to the venous access selected. Conclusions: there are no differences in terms of duration of catheters according to their length, vein of insertion or COVID-19 diagnosis. Ultrasound-guided venipuncture, sterile technique and selection of type of catheter by a member of the IVAN team seem to reduce the complications associated. © 2022 DAE Editorial, Grupo Paradigma. All rights reserved.

Influence of COVID-19 on the work environment of health workers in Ecuador

Introduction: the quality of medical care is directly related to the appropriate work environment and the satisfaction of the health staff. With the appearance of COVID-19, the work environment in health institutions has worsened. Background: to identify the factors that influence the work environment of the public and private health institutions of Santo Domingo de los Tsachilas, Ecuador, during the period June-August 2021. Method: implementation of a study with a quantitative approach of correlational scope and transectional design in 349 health workers, to whom a 25-questions questionnaire was applied, that measured factors such as: contagion risk, working hours, medical resources and job stability. The results of the study were statistically analyzed through SPPS 20 and AMOS 24, with the previous development of Cronbach's alpha. Results: 94% of the participants considered the work environment of their institutions as inappropriate, while 6% said they did not. Females, and ages ranging between 22-35 years predominated. All the variables of the hypothesized model exceeded 0.70 and the total Cronbach's alpha reached 0.728;the hypothesized model met the convergent and discriminant validity of the variables. The risk of contagion yielded a value of beta=0.148, while the working day resulted with beta=0.010, medical resources beta=0.006 and job stability beta=0.007. Conclusions: the findings determined that the risk of contagion is the most influential factor in the work environment of the institutions under study during the beginning of the COVID-19 pandemic.