ABSTRACT
The use of a subcutaneous engineered securement device (SESD) for peripherally inserted central catheters (PICC) in an acute care setting was found to have a direct impact on central line associated bloodstream infection (CLABSI) rates compared to traditional adhesive engineered securement devices (AESD). OBJECTIVE: While the literature suggests the use of SESDs has had successful results for device securement, it is unknown to what extent they may impact CLABSI rates. Securement and stabilization performance among devices may be a direct risk factor for CLABSIs. METHODS: A retrospective quality review of 7,776 cases was conducted at a large academic medical center. The primary researcher implemented a quantitative design which was analyzed with demographics statistics and relative risk ratio. RESULTS: There was a 288% (nâ¯=â¯47) increase in relative risk of CLABSI found in the AESD group compared to the SESD group. The results imply the use of SESDs may improve nursing practice and patient outcomes lowering CLABSI rates in patients with PICCs by a reduction of risks associated with securement design differences.
Subject(s)
Catheter-Related Infections , Catheterization, Central Venous , Catheterization, Peripheral , Central Venous Catheters , Catheter-Related Infections/epidemiology , Catheter-Related Infections/prevention & control , Catheterization, Central Venous/adverse effects , Catheterization, Peripheral/adverse effects , Central Venous Catheters/adverse effects , Hospitals, University , Humans , Retrospective StudiesABSTRACT
108 patients were treated between 1/06/97 and 7/19/99. Ages ranged from 53 years to 82 years. Pretreatment PSA ranged from 4.0 to 34.6 and post treatment PSA from 0 to 7.3. Given the fact that carcinoma of the prostate is a relatively slow growing tumor and that long survival times are not uncommon even in the face of relatively advanced disease, our treatment team believes that the preferred method of treatment in otherwise healthy patients who have a 20 year life expectancy is radical surgery. We do believe that brachytherapy has a role in the treatment of organ-confined disease and may possibly be proven to be as effective as surgery; however, until there is at least 15-year data, it cannot be considered as the primary treatment of choice in young men. The senior author has stressed the term "treatment team" in this paper for a reason. We sincerely believe that the best results for our patients are obtained when we approach the treatment of the patient as a unified team that makes use of our individual talents and training for the good of the patient as a whole. Each member of the team performs the procedures that he is best trained to do, and we are consistent in our approach and advice to our patients regardless of our disciplines.
Subject(s)
Adenocarcinoma/therapy , Brachytherapy/methods , Prostatic Neoplasms/therapy , Adenocarcinoma/diagnostic imaging , Aged , Aged, 80 and over , Brachytherapy/adverse effects , Humans , Male , Middle Aged , Prognosis , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnostic imaging , UltrasonographyABSTRACT
Thirty-one patients underwent a negative second-look laparotomy between 1976 and 1986. Fourteen patients received intraperitoneal chromic phosphate (P-32) after a negative second-look laparotomy. There has been no local recurrence (zero of 14) and no deaths attributable to recurrent disease. Local control and disease-free survival are 100%, with a minimum follow-up of 2 years and a mean follow-up of 4 years. Seventeen patients received no further therapy because of patient refusal, poor diffusion, or other contraindications to P-32 installation. Four of 17 patients undergoing negative second-look procedures without the addition of P-32 have subsequently recurred. This difference is highly suggestive (P = .076). There have been no major complications with the addition of P-32. The use of intraperitoneal P-32 after negative second-look laparotomies on ovarian carcinoma is well tolerated and effective in preventing recurrence.
