Readings in "Prevention of Peripheral Venous Catheter

CENTRAL PHILIPPINE UNIVERSITY
COLLEGE OF NURSING
Jaro, Iloilo City, Philippines
Readings in “Prevention of Peripheral Venous Catheter

Complications With an Intravenous Therapy Team A
Randomized Controlled Trial”
SUBMITTED BY:
DEGUIA, PATRICIA NICOLE C.
BSN 4C
Background. More than 25 million patients have peripheral intravenous (IV) catheters placed
each year in US hospitals. Infusion therapy is believed to account for one third of all nosocomial
bacteremias. One of the most common invasive procedures performed in hospitals is the
placement of an intravenous (IV) catheter for the administration of parenteral therapy. In the
United States, more than 25 million patients have peripheral IV catheters placed each year, and
infusion therapy is thought to account for one-third of all nosocomial bacteremias. Because
infusion therapy is a major cause of morbidity, the Centers for Disease Control and Prevention
has established guidelines for IV catheter insertion and maintenance, which have recently been
updated.
Methods. We performed a randomized, prospective, controlled study in a university-affiliated

hospital to determine whether the use of an IV therapy team decreases peripheral venous
catheter–related complications in adult medical patients. Patients were randomized to undergo
peripheral catheter insertion and/or maintenance either by the IV team or by medical house
staff. A dedicated observer reviewed catheter sites daily; findings were applied to a scoring
system to define the severity of complications. Bacteremic complications were reviewed by a
physician.
Results. Patients with catheters started by the house staff and maintained by ward nursing staff
more often had signs or symptoms of inflammation (21.7%) than did patients with catheters
maintained by the IV team (7.9%) (P<.001). Patients monitored by the IV team had a greater
mean number of catheters placed per patient than did patients monitored by house staff (2.1
and 1.6, respectively) (P<.01). Three episodes of catheter-related sepsis occurred in house staff
patients and none in IV team patients (P=.004).
Conclusions. An IV therapy team significantly reduced both local and bacteremic complications
of peripheral IV catheters. Timely replacement of the catheter appeared to be the most
important factor in reducing the occurrence of complications. This study shows that an IV
therapy team's efforts can significantly reduce local and infectious complications associated with
peripheral IV catheters. The overall local complication rate in house staff catheters was 21.7%,
while it was 7.9% in IV team catheters. The local complication rate was higher in the house staff
catheters for each day observed, as was the rate of multiple complications.
REFERENCES:
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/191528
Readings in “Impact of Blood Transfusions and Transfusion
Practices on Long-Term Outcome Following
Hepatopancreaticobiliary Surgery”
Background. The long-term impact of transfusions with packed red blood cells (PRBC) among
patients undergoing hepatopancreaticobiliary (HPB) surgery remains ill-defined. We sought to
determine the impact of overall blood utilization, as well as a restrictive transfusion strategy, on
long-term outcomes among patients undergoing an HPB resection for a malignancy. A blood
transfusion is a common procedure in which you are given donated blood or blood components
via an intravenous line (IV). A blood transfusion is used to replenish blood and blood
components that have become depleted.
Methods. Data on overall blood utilization and hemoglobin (Hb) levels that triggered a
transfusion were obtained for patients with cancer undergoing pancreas or liver surgery
between 2009 and 2013. Risk-adjusted recurrence-free (RFS) and overall survival (OS) were
assessed based on receipt of PRBC and whether the patient received a transfusion using a
restrictive transfusion strategy (intraoperative: Hb <10 g/dL; postoperative: Hb <8 g/dL).
Results. Four hundred forty-two patients underwent either a pancreas (58.1 %) or liver (41.9 %)
resection. Most tumors were pancreatic in origin (41.8 %), while a subset were primary (23.1 %)
or secondary (18.8 %) liver tumors. One hundred seventy-five (39.6 %) patients received ≥1
PRBC transfusion either intraoperatively (16.7 %), postoperatively (12.7 %), or both (10.2 %).
There was a higher incidence of PRBC transfusion among patients undergoing a pancreas
resection, those with higher comorbidities, and those with lower preoperative Hb levels.
Perioperative morbidity was higher among patients receiving either 1–2 units (OR 3.14) or 3 or
more units of PRBC (OR 8.54). Median OS was 31.9 months. Receipt of a blood transfusion
was associated with a worse OS (1–2 units: HR 1.76; 3 + units: HR 2.50; both P < 0.05), and
RFS (3 + units: HR 2.91; P = 0.02). Utilization of a restrictive transfusion strategy did not impact
perioperative morbidity or long-term RFS or OS.
Conclusions. Adoption of a more restrictive transfusion strategy in patients undergoing
resection for cancer may preserve a limited resource, reduce costs, as well as avoid exposing
oncology patients to the unnecessary risks associated with a transfusion.
REFERENCES:
https://link.springer.com/article/10.1007/s11605-015-2776-5

Readings in "Prevention of Peripheral Venous Catheter

Uploaded by

Copyright:

Available Formats

Readings in "Prevention of Peripheral Venous Catheter

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Readings in "Prevention of Peripheral Venous Catheter

Uploaded by

Copyright:

Available Formats

CENTRAL PHILIPPINE UNIVERSITY

Readings in “Prevention of Peripheral Venous Catheter

Methods. We performed a randomized, prospective, controlled study in a university-affiliated

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.