Phlebitis Incidence Associated to Peripherally Inserted Central Catheters in Adults ICU: Implementation of a Nursing Protocol
Abstract
Phlebitis incidence related to peripherally inserted central catheters (PICCs): New nursing protocol application. Phlebitis is one of the most common complications of peripherally inserted central catheters (PICCs). The scientific evidence about the utility of measuring scales to phlebitis diagnosis is very limited.Objectives: Compare phlebitis incidence rate before and after the introduction of a new protocol.
Materials and Methods: Retrospective cohort study in 159 patients admitted to the intensive care unit (ICU) for two years. First we assess phlebitis in 59 patients (group 1). After that we apply a new protocol to identify phlebitis with visual score and continuous evaluation to 100 patients (group 2)
Results: the probability of being diagnosed of phlebitis is significantly smaller in group 2 (or: 0.009, i.c. 95% 0,01-0,52)
Conclusions: the protocol application reduced the diagnosis of phlebitis in 90%
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References
Fitchie C. Central venous catheter-related infection and dressing type. Intensive Crit Care Nurs. 1992;8(4):199-202.
Mazzola JR, Schott-Baer D, Addy L. Clinical factors associated with the development of phlebitis after insertion of a peripherally inserted central catheter. Journal of Intravenous Nursing.1999;22(1):36 - 42.
Gomez Palomar C, Miquel Perez T. Catéter venoso central de inserción periférica con múltiples luces: una buena opción para monitorizaciónn de presión y tratamiento. Enferm Cardiol. 2009; XVI(47-48):99-103.
Chlebicki MP, Teo EK .Review of peripherally inserted central catheters in the Singapore acute-care hospital. Singapore Med J. 2003; 44(10):531-35.
Cotogni P, Pittiruti M. Focus on peripherally inserted central catheters in critically ill patients. World J Crit Care Med. 2014;3(4):80-94.
Miyagaki H, Nakajima K, Hara J, Yamasaki M, Kurokawa Y, Miyata H, Takiguchi S, Fujiwara Y, Mori M, Doki Y. Performance comparison of peripherally inserted central venous catheters in gastrointestinal surgery: a randomized controlled trial. Clin Nutr. 2012; 31(1):48-52.
Harter C, Ostendorf T, Bach A, Egerer G, Godschmidt H, Ho AD. Peripherally inserted central venous catheters for autologous blood progenitor cell transplantation in patients with haematological malignancies. Support Care Cancer. 2003;11(12):790-4
Vivien R Griffiths, Peter Philpot. Peripherally inserted central catheters (PICCs): do they have a role in the care of the critically ill patients. Intensive and critical care nursing 2002; 18(1): 37-47.
Di Giacomo, M. Comparison of three peripherally-inserted central catheters: pilot study. British Journal of Nursing. 2009; 18(1):8-16.
Hata Y, Morita S, Morita Y, Awatani T, Takasaki M, Horimi T, Ozawa Z. Peripheral insertion of a central venous access device under fluoroscopic guidance using a peripherally accessed system (PAS) port in the forearm. Cardiovasc Intervent Radiol.1998; 21(3):230-3.
Stephen C, Loughran and Marcello Borzatta, M .Peripherally Inserted Central Catheters: A Report of 2506 Catheter Days. J Parenter Enteral Nutr.1995; 19(2):133–6.
Ong CK, Venkatesh SK, Lau GB, Wang SC. Prospective randomized comparative evaluation of proximal valve polyurethane and distal valve silicone peripherally inserted central catheters. J Vasc Interv Radiol. 2010; 21(8): 1191 – 6.
Nichols I, Humphrey JP. The efficacy of upper arm placement of peripherally inserted central catheters using bedside ultrasound and microintroducer technique. J Infus Nurs. 2008; 31(3):165-76.
Park JY, Kin HL. A comprehensive review of clinical nurse spcialist-led peripherally inserted central catheter placement in Korea: 4101 cases in a tertiary hospital. J. Infus Nursing 2015; 38(2):122-8
Gillian Ray-Barruel, Denise F. Folit. Infusion phlebitis assessment measures: a systematic review. Journal of evaluation in clinical practice 2014; 20(2): 191-202.
Seguridad del Paciente. Proyecto Bacteriemia Zero. [Acceso 20 Diciembre de 2014]. Disponible
en:http://www.seguridaddelpaciente.es/es/proyectos/financiacion-estudios/proyecto-bacteriemia-zero/
Knaus WA.APACHE II. Final form and national validation results of a severity of disease classification system. Crit Care Med.1984; 12(3):213-63.
Jackson A. Infection control: a battle in vein infusion phlebitis. Nursing Times. 1998; 94(4):68-71.
Ng PK, Ault MJ, Maldonado LS. Peripherally inserted central catheters in the intensive care unit. J Intensive Care Med.1996; 11(1):49-54.
Ferrete-Morales C, Vázquez-Pérez M A, Sánchez-Berna M; Gilabert-Cerro I, Corzo-Delgado J E, Pineda-Vergara J A, et al. Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol. Enferm Clin. 2010;20(1):3-9.
Proyecto flebitis Zero. [Acceso 18 de junio de 2015]. Disponible en:http://flebitiszero.com/app/
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