ABSTRACT
The management of nursing care regarding patients' vascular access is a priority. This study determines the contribution of the variables involved in the quality of care and maintenance of vascular access (VA) devices in admitted patients in the Valencian Community. METHODS: Using the STROBE statement, an observational, cross-sectional study was conducted on 1576 VA devices. Data were collected using the INCATIV Questionnaire. We performed a multivariate analysis of the questionnaire variables. RESULTS: In total, 50% had a good or very good assessment of the VA condition. This was positively correlated with anatomical location, dressing type, dressing date record, use of needle-free connectors (NFCs), date of last dressing change, presence of phlebitis, visibility of the insertion site and characteristics of the dressing's condition (p < 0.001). The model indicated that the presence of phlebitis was the clearest predictor of a poor VA care assessment (OR = 20.579), followed by no visibility of the insertion site (OR = 14.209). Results also indicated that uncovered VA lumens or no NFCs used were related to a negative quality assessment. CONCLUSION: By managing and controlling these variables, the likelihood of providing optimal care is ensured. This enables the establishment of a standardised care approach for all nursing professionals and the building of a new quality indicator.
ABSTRACT
BACKGROUND: More than one billion of peripheral venous catheters are inserted into hospitalized patients every year. This study sought to identify the status of nursing care in vascular accesses in different hospitals and to evaluate the impact of a series of informative and formative interventions aimed at their care. METHODS: Quasi-experimental, multicenter study. A total of 54 nursing professionals of 19 hospitals participated. The intervention consisted of informative talk and three training sessions related to the care and maintenance of vascular accesses and intravenous therapy in the hospital-admitted adult population. This was delivered in four years, with eight periodic cross-sectional assessments conducted before and after each intervention. To assess quality of nursing care in vascular accesses and intravenous therapy, a quality indicator called Standard Variable (VES), was developed and validated with the Delphi methodology. RESULTS: A total of 21,108 patients, aged 64.0 years (SD 18.3), were assessed, of which 78.3% (16,516) had some type of vascular access inserted. An average of 22.1% (95% CI: 21.4-22.7) were classified as optimal. In total, 3218 nursing care professionals took part in the training activities. The VES indicator grew steadily throughout the study, raising from 7.8% to 37.6%. Changes were statistically significant between those time points in which one of the described interventions was delivered; however, there were no significant changes between time points with no intervention. CONCLUSIONS: This study supports that continuous training interventions can produce improvements in the quality of nursing care and reduce complications in patients with vascular accesses. In addition, the VES indicator was a useful and simple tool to measure quality, but the experience with its use suggests continuous research in the search for standardized indicators that objectify the evaluation and evolution of care.
Subject(s)
Hospitalization , Hospitals , Adult , Humans , Cross-Sectional Studies , Middle Aged , AgedABSTRACT
Nosocomial infections or infections related to health-care system have a great impact in the healthcare due to its high frequency and high morbidity and mortality they caused. Inside of them, there are the catheter-related bacteraemia. The paper of the nursing in the care and maintenance of the intravenous therapy is basic to avoid this type of infections. There has been demonstrated the efficacy of the implementation of catheter-related infections prevention programmes through a bundle of measures about the insertion, maintenance, surveillance and prevention of adverse events in the vascular access. The aim of this work is to show and emphasize the last updated recommendations collected in the 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections to nursing staff.
Subject(s)
Catheter-Related Infections/prevention & control , Centers for Disease Control and Prevention, U.S. , Practice Guidelines as Topic , Humans , United StatesABSTRACT
Las infecciones nosocomiales o las adquiridas durante la asistencia sanitaria tienen un gran impacto en el sistema sanitario, por su elevada frecuencia y por la morbimortalidad que ocasionan. Dentro de ellas encontramos las bacteriemias relacionadas con catéter (BRC). El papel de la enfermería en el cuidado y mantenimiento de la terapia intravenosa es fundamental para evitar este tipo de infecciones. Se ha demostrado la eficacia de la implantación de programas de prevención de infecciones relacionadas con catéter a través de paquetes de medidas de prevención y procedimientos de trabajo en la inserción, mantenimiento, atención permanente y prevención de eventos adversos en los accesos vasculares. Por ello, con este trabajo se pretende dar a conocer y enfatizar las recomendaciones recogidas y actualizadas en 2011 por los CDC en la «Guía para la Prevención de Infecciones Relacionadas con Dispositivos Intravasculares» para los profesionales de enfermería (AU)
Nosocomial infections or infections related to health-care system have a great impact in the healthcare due to its high frequency and high morbidity and mortality they caused. Inside of them, there are the catheter-related bacteraemia. The paper of the nursing in the care and maintenance of the intravenous therapy is basic to avoid this type of infections. There has been demonstrated the efficacy of the implementation of catheter-related infections prevention programmes through a bundle of measures about the insertion, maintenance, surveillance and prevention of adverse events in the vascular access. The aim of this work is to show and emphasize the last updated recommendations collected in the 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections to nursing staff (AU)
Subject(s)
Humans , Catheter-Related Infections/prevention & control , Cross Infection/prevention & control , Bacteremia/prevention & control , Catheters, Indwelling/standards , Centers for Disease Control and Prevention, U.S. , Practice Guidelines as Topic , Nursing Care/standardsABSTRACT
Guía dirigida a todos los médicos, en especial a aquellos que atiendan a trabajadores afectados de problemas de salud de posible origen laboral en los servicios de prevención de las empresas o en los centros de Atención Primaria o Especializada. Contiene: las enfermedades profesionales, el Sistema de Comunicación de Sospechas de Enfermedades Profesionales en la Comunidad Valenciana, listado de diagnósticos y criterios de sospecha, anexos.
Subject(s)
Occupational Health , Occupational Medicine , Occupational Risks , Occupational Diseases , 28441 , Surveillance of the Workers HealthABSTRACT
La utilización de sistemas de extracción al vacío dotados de dispositivo de seguridadbiológica es el método más seguro y de mayor calidad para la extracciónde sangre venosa. La utilidad de los porta-tubos viene determinada porla protección que ofrece al profesional frente al pinchazo con la aguja de inserciónen el tubo, a la posibilidad de salpicaduras tanto en la inserción comoen la desinserción de la aguja sobre el tubo y al ofrecer un centrado perfectoen la inserción de la aguja sobre el tapón de caucho del tubo, lo que permiteuna correcta técnica de vacío. Los dos grandes problemas generados por lautilización del sistema de extracción al vacío y la reutilización de los porta-tubosson el riesgo de exposición y pinchazo accidental al separar la aguja/palomilladel porta-tubos y el de contaminación cruzada e infección nosocomialpara el paciente. Se ha comprobado que se necesitan procedimientos extensospara tratar eficazmente los porta-tubos destinados a reutilización múltiple.Con el presente artículo se pretende revisar la normativa referida a la exposiciónocupacional a patógenos sanguíneos, recordar los riesgos por contaminacióncruzada, difundir algunos aspectos del Proyecto Piloto del Programa de Prevencióndel Riesgo Biológico que se ha desarrollado en la Comunidad Valencianay establecer algunas recomendaciones en materia de prevención, ligadasa esta situación
The use of vacuum blood extraction systems equipped with a biological safetydevice is the safest and highest quality method for extracting venous blood.The usefulness of probe collector trays for blood transport is provided by theprotection given to the professional against accidental puncture with the insertionneedle into the catheter, the chance of blood splashes, both during theinsertion as well as the withdrawal of the needle from the catheter and a perfectcentering mechanism for the insertion of the needle on the rubber tap ofthe catheter, allowing a precise vacuum technique. The two main problems ofvacuum blood extraction and the re-utilisation of the probe collector tray arethe risk of exposure and accidental puncture when separating the needle/butterflyneedle from the probe collector and cross-contamination and nosocomialinfection for the patient. It has been demonstrated that extensive proceduresare needed to effectively handle probe collector trays destined to multiple reutilisation.This papers is intended to review the norms and regulation relating to occupationalexposure to blood pathogens, to remind the professional of the risksof cross contamination, to disseminate some aspects of the Pilot Project of theBiological Risk Prevention Program developed by the Comunidad Valencianaand to establish some recommendations in terms of prevention associated to this procedure (AU)
Subject(s)
Humans , Blood Specimen Collection/instrumentation , Blood Specimen Collection/methods , Pipelines , Occupational Exposure/prevention & control , Cross Infection/prevention & control , Occupational Exposure/standards , Protective Devices , Security Measures , Risk Management , SpainABSTRACT
Due to the fact that complications from infections are more frequent and serious related to intravenous therapy it is necessary to implement multidisciplinary measures which reduce their incidence. The recommendations made by the CDC help to guarantee the quality of the services which nursing professionals provides to patients when applying this procedure.
Subject(s)
Catheterization/standards , Communicable Disease Control/methods , Infusions, Intravenous/standards , HumansABSTRACT
Puesto que las complicaciones infecciosas son las más frecuentes y graves en relación a la terapia intravenosa, es preciso implementar medidas multidisciplinarias que reduzcan su incidencia. Las recomendaciones efectuadas por los CDC's ayudan a garantizar la calidad de los servicios que presta enfermería al respecto de este procedimiento
Due to the fact that complications from infections are more frequent and serious related to intravenous therapy, it is necessary to implement multidisciplinary measures which reduce their incidence. The recommendations made by the CDC help to guarantee the quality of the services which nursing professionals provides to patients when applying this procedure
