Vascular Access Devices (Vad) and Covid+19 Patiens Not Admitted in the Icu

The study of COVID-19 patient's management with vascular access has been very low but a consensus has been reached to improve care in this type of patient. The importance of care, the proper choice of the vascular access device (DAV), the reduction of adverse effects and the minimization of contagion risks by health personnel are a new axis of study. AIM Highlight the work of the Vascular Access Unit from Arnau de Vilanova Hospital with Covid 19 patients who didn't require admission to the Intensive care Unit. Methodology: Observational, descriptive and retrospective study by auditing the digitized medical records of 52 patients with medical discharged from the Arnau de Vilanova hospital from March 2019 to December 2021. Result(s): The 90% of DAVs were removal at the end of the therapy. In the 100% of the cases the first change dressing was 7 days later the insertion due to the use of cyanoacrylate use at the exit site. The average use was 16 days. 5 devices were remove for malfunction, 12 for exitus and 35 were removed for end of treatment. The average number of days from the time the patient is admitted until the day insertion is requested is 5 days. Conclusion(s): The existence of a UAV has meant an increase in patient safety and has allowed to be carried out the therapy for COVID 19 patients who were not included in the ICU The UAV has been able to insert the DAVs at bedside, improving the safety profile of the personnel. The use of new materials such as cyanoacrylate has reduced the workload and the risk of occupational exposure, while also reducing costs.

Vascular Accesses Used in the Administration of Antineoplasic Therapy in an Oncological Day Hospital

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.

Vascular Access and Covid-19 Pandemic in a Quality Program for Intravenous Therapy in Spain (Incativ)

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.