Background= CVPs are currently the most used devices in hospitals, as between 60% and 90% of hospital patients have a clinical need for their insertion. These devices can present complications, in J. Webster's randomized controlled study the failure rate is between 35% and 50%. Issues that lead to catheter removal before the end of the intended use time or before its removal upon discontinuation of infusion therapy manifest themselves in the form of phlebitis, infiltration, occlusions, mechanical failure, displacement and infection, alone or in combination. It was estimated in the cross-sectional study by F. Canzan in a hospital setting that one CVP in four is kept in place unused for up to three days, despite this being an infectious risk factor for the patient.3 4 Objective: The objective of this investigation is to detect, through data collection, the level of adherence to the company protocol in the management of peripheral venous catheters in daily internal clinical practice and to identify useful methods for improving patient comfort. Materials and methods: the survey was carried out at three hospital ward of the medical area Cardiology, Neurology and Emergency Medicine, data collection began in August 2023 and ended in September 2023. For the survey, an instrument reproduced and modified from a recent publication of good nursing practices by F. was used. Catarino published in Nursing Report in 2022 is focused on three main macro-categories: general patient data, short CVP data and objective data collected at the time of the patient's consent interview for a total of 17 items. 19 Results: presence of the date on the device dressing 88.2%, number of devices with alterations 23.5%, percentage of devices reported in the medical records 52.9%, 23.6% of patients with absent intravenous therapy but with a CVP in place. Conclusions: The survey highlighted good adherence to the guidelines for the management of venous access, some critical issues regarding correct registration in the medical record and the presence of some unused devices. Keywords: “catheterization”, “Peripheral”, “peripheral catheter related complication”, “catheter related complication”, “catheter care”, “intravenous complication”.
Background= I CVP sono ad oggi i device più utilizzati in ambito ospedaliero, in quanto tra il 60 % e il 90% dei pazienti degenti hanno necessità clinica di un loro inserimento. Questi dispositivi possono presentare delle complicanze, nello studio randomizzato controllato di J. Webster la percentuale di insuccesso è compreso tra il 35% e il 50%. Le problematiche che portano alla rimozione del catetere prima della fine del tempo di utilizzo previsto o prima della sua rimozione alla sospensione della terapia infusionale si manifestano sottoforma di flebiti, infiltrazioni, occlusioni, guasto meccanico, spostamento e infezione, da soli o in combinazione. E stato stimato nello studio trasversale da F. Canzan in ambito ospedaliero che un CVP su quattro viene mantenuto in sede non utilizzato fino ad un tempo maggiore di tre giorni, nonostante questo sia un fattore di rischio infettivo per il paziente.3 4 Obiettivo: L’obbiettivo di questa indagine è di rilevare attraverso una raccolta dati il livello di aderenza al protocollo aziendale nella gestione dei cateteri venosi periferici nella pratica clinica quotidiana internistico e individuare metodiche utili al miglioramento del comfort del pz. Materiali e metodi: la rilevazione è stata svolta presso tre UU.OO. di area medica Cardiologia, Neurologia e Medicina d’urgenza, la raccolta dati è iniziata ad Agosto 2023 e si è conclusa a Settembre 2023. Per la rilevazione è stato utilizzato uno strumento riprodotto e modificato da una recente pubblicazione di buone pratiche Infermieristiche di F. Catarino pubblicata su Nursing Report nel 2022 è focalizzato su tre principali macrocategorie: dati generali del paziente, dati del CVP corto e dati oggettivi rilevati al momento del colloquio per il consenso del pz per un totale di 17 item. 19 Risultati: presenza della data sulla medicazione del device 88,2%, numero dispositivi con alterazioni 23,5 %, percentuale dispositivi riportati in cartella 52,9%, 23,6% dei pazienti con terapia endovenosa assente ma con un CVP in sede. Conclusioni: La rilevazione ha evidenziato una buona adesione alle linee guida per la gestione degli accessi venosi, alcune criticità riguardanti la corretta registrazione in cartella e la presenza di alcuni device inutilizzati. Parole chiave: “catheterization”, “Peripheral”, “peripheral catheter related complication”, “catheter related complication”, “catheter care”, “intravenous complication”.
Aderenza alle raccomandazioni nella gestione degli accessi venosi periferici
CAPPOZZO, NATASHA
2022/2023
Abstract
Background= CVPs are currently the most used devices in hospitals, as between 60% and 90% of hospital patients have a clinical need for their insertion. These devices can present complications, in J. Webster's randomized controlled study the failure rate is between 35% and 50%. Issues that lead to catheter removal before the end of the intended use time or before its removal upon discontinuation of infusion therapy manifest themselves in the form of phlebitis, infiltration, occlusions, mechanical failure, displacement and infection, alone or in combination. It was estimated in the cross-sectional study by F. Canzan in a hospital setting that one CVP in four is kept in place unused for up to three days, despite this being an infectious risk factor for the patient.3 4 Objective: The objective of this investigation is to detect, through data collection, the level of adherence to the company protocol in the management of peripheral venous catheters in daily internal clinical practice and to identify useful methods for improving patient comfort. Materials and methods: the survey was carried out at three hospital ward of the medical area Cardiology, Neurology and Emergency Medicine, data collection began in August 2023 and ended in September 2023. For the survey, an instrument reproduced and modified from a recent publication of good nursing practices by F. was used. Catarino published in Nursing Report in 2022 is focused on three main macro-categories: general patient data, short CVP data and objective data collected at the time of the patient's consent interview for a total of 17 items. 19 Results: presence of the date on the device dressing 88.2%, number of devices with alterations 23.5%, percentage of devices reported in the medical records 52.9%, 23.6% of patients with absent intravenous therapy but with a CVP in place. Conclusions: The survey highlighted good adherence to the guidelines for the management of venous access, some critical issues regarding correct registration in the medical record and the presence of some unused devices. Keywords: “catheterization”, “Peripheral”, “peripheral catheter related complication”, “catheter related complication”, “catheter care”, “intravenous complication”.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/58211