Evaluation of Indicators of a Vascular Access Device Program led by Nursing Professionals in a High-complexity University Hospital in Colombia
DOI:
https://doi.org/10.17533/udea.iee.v40n1e12Keywords:
vascular access devices, hospitalization, nursing careAbstract
Objective. This work sought to evaluate result indicators of the specialized vascular access program led by nursing during the period between 01 January 2018 and 31 December 2019 at Fundación Cardioinfantil -Instituto de Cardiología (Colombia).
Methods. This was a retrospective descriptive study based on medical records of 1,210 patients who received insertion of vascular access devices by the specialized group of nurses. Result indicators are described.
Results. Of all the patients who received insertion of a vascular access catheter, 53.1% were women, with mean age of 34.2 years, admitted to critical care services with cardiovascular problems and sepsis (90.2%). Placement of the peripherally inserted central catheter, midline and arterial was echo-guided between 91% and 100%, with a success rate on the first puncture of 66%. The average duration time of the peripherally inserted central catheter was 25.3 days, that of the midline catheter was 8 days, with a reach of 57% until the end of the treatment. The rate observed per catheter-days of overall phlebitis was 2.03, for positive blood culture of the central peripheral insertion device was 1.9 and thrombosis of 0.50; and arterial line thrombosis was 11.7.
Conclusion. The Vascular Access Device Program led by nursing reported rational use of these elements with structured therapeutic purposes according with the complexity of the patients admitted to hospitalization. Improvement plans must be implemented to increase efficacy in post-admission insertion times, reduce infection rate and thrombosis through effective follow-up and control mechanisms.
Downloads
References
1. Ling M.L, Apisarnthanarak A, Jaggi N, et al. APSIC guide for prevention of Central Line Associated Bloodstream Infections (CLABSI). Antimicrob Resist Infect Control. 2016; 5(16). https://doi.org/10.1186/s13756-016-0116-5.
2. Centers for Disease Control and Prevention. Checklist for Central Line Associated Bloodstream Infections. (cited 15 Dec 2021. Available from: https://www.cdc.gov/hai/pdfs/bsi/checklist-for-CLABSI.pdf.
3. O’Neil C, Ball K, Wood H, McMullen K, Kremer P, Jafarzadeh, S., et al. A Central Line Care Maintenance Bundle for the Prevention of Central Line–Associated Bloodstream Infection in Non–Intensive Care Unit Settings. Infect. Control Hosp. Epidemiol. 2016; 37(6):692-8.
4. Muñoz T R, Marín NLo LM, Gallego-Sánchez JC. Cuidados de Enfermería en los accesos vasculares Guía de Recomendaciones. España. Edita: Área de Salud de Badajoz; 2019.
5. Gorski L, Hadaway L, Hagle ME, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J. Infus. Nurs. 2019; 39(1S)2016. Available from: http://source.yiboshi.com/20170417/1492425631944540325.pdf
6. Caballero AF, Villarreal K. Ultrasound for central vascular access. A safety concept that is renewed day by day: review. Rev. Colomb. Anestesiol. 2018; 46(Suppl. 1):32-8.
7. Gorski LA, Hadaway L, Hagle ME, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J. Infus Nurs. 2021; 44(suppl 1):S1-S224.
8. Foka M, Nicolaou E, Kyprianou T, Palazis L, Kyranou M, Papathanassoglou E, Lambrinou E. Prevention of Central Line-Associated Bloodstream Infections Through Educational Interventions in Adult Intensive Care Units: A Systematic Review. Cureus. 2021; 3(8):e17293.
9. Pathak R, Gangina S, Jairam F, Hinton K. A vascular access and midlines program can decrease hospital-acquired central line-associated bloodstream infections and cost to a community-based hospital. Clin. Risk Manag. 2018; 14:1453-6.
10. Thate JA, Couture B, Schnock KO, Rossetti SC. Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line–associated blood stream infections. Comput. Inform. Nurs. 2021; 39(4):208–14.
11. Chapman LB, Kopp KE, Petty MG, Hartwig JL, Pendleton KM, Langer K, et al. Benefits of collaborative patient care rounds in the intensive care unit. Intensive Crit. Care Nurs. 2021; 63:102974.
12. U.S. Department of Health and Human Services. National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination [Internet]. (cited 21 Apr 2021). Available at: https://health.gov/our-work/health-care-quality/health-care-associated-infections.
13. Xiong Z, Chen H. Interventions to reduce unnecessary central venous catheter use to prevent central-line–associated bloodstream infections in adults: a systematic review. Infect. Control Hosp. Epidemiol. 2018; 39(12):1442–8.
14. Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed. Mater. Eng. 2013; 23(1-2):93-108.
15. Iordanou S, Middleton N, Papathanassoglou E, Palazis L, Raftopoulos V. Should the CDC's recommendations for promptly removing unnecessary centrally inserted central catheters be enhanced? Ultrasound-guided peripheral venous cannulation to fully comply. J. Vasc. Access. 2020; 21(1):86-91.
16. Elkhunovich M, Barreras J, Bock Pinero V, Ziv N, Vaiyani A, Mailhot T. The use of ultrasound for peripheral IV placement by vascular access team nurses at a tertiary children's hospital. J. Vasc. Access. 2017; 18(1):57-63.
17. Pallejà Gutiérrez E, López Carranza M, Jiménez PL, Vilches PL. Catéteres venosos de inserción periférica (PICC): un avance en las terapias intravenosas de larga permanencia. Nutr.Clín. Med. 2017; 11(2):114-7.
18. Beville ASM, Heipel D, Vanhoozer G, Bailey P. Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days. Curr. Infect. Dis. Rep. 2021; 23(12):23.
19. Johann DA, Danski MT, Vayego SA, Barbosa DA, Lind J. Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial. Rev. LatAm Enfermagem. 2016; 24:e2833.
20. Haddadin Y, Regunath H. Central line associated blood stream infections (CLABSI). StatPearls. Epub 2017 Mar 28.
21. Morrell E. Reducing Risks and Improving Vascular Access Outcomes. J. Infus. Nurs. 2020; 43(4):222-8.
22. Fernández AY, García A, Orviz J, Fernández A, Del Valle M, González E. Device Selection for Vascular Access Guideline implementation at a regional hospital intensive care unit (ICU). Int. J. Integr. Care. 2019; 19(4):552.
23. Ista E, van der Hoven B, Kornelisse RF, van der Starre C, Vos MC, Boersma E, Helder OK. Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages: a systematic review and meta-analysis. Lancet Infect. Dis. 2016; 16(6):724-34.
24. Iordanou S, Middleton N, Papathanassoglou E, Palazis L, Raftopoulos V. Should the CDC's recommendations for promptly removing unnecessary centrally inserted central catheters be enhanced? Ultrasound-guided peripheral venous cannulation to fully comply. J. Vasc. Access. 2020; 21:86–91.
Downloads
Published
Versions
- 2023-09-20 (2)
- 2022-03-28 (1)
How to Cite
Issue
Section
License
Copyright (c) 2022 Investigación y Educación en Enfermería
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Derechos de propiedad / Direitos de Propriedade
English: If the article is accepted for publication, all copyright will be of exclusive property of Investigación y Educación en Enfermería. The text and the graphics included in the publication are exclusive responsibility of the authors and not necessarily reflect the thought of the Editorial Committee.
Español: Si el artículo es aprobado para publicación, todos los derechos son de propiedad de Investigación y Educación en Enfermería. El texto y las gráficas incluidas en la publicación son de exclusiva responsabilidad de los autores y no necesariamente refleja el pensamiento del Comité Editorial.
Português: Se o artigo for aceito para publicação, todos os direitos autorais serão de propriedade exclusiva de Investigación y Educación en Enfermería. O texto e os gráficos incluídos na publicação são de responsabilidade exclusiva dos autores e não refletem necessariamente o pensamento do Comitê Editorial.