RESUMEN
Objectives: To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Method: Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. Results: The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. Final considerations: The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools.
Objetivos: Identificar quais são as dificuldades da equipe de Enfermagem no manejo das tecnologias durante a terapia intravenosa (TIV) e discutir as dificuldades identificadas sob a perspectiva da segurança do paciente. Métodos: abordagem qualitativa, do tipo descritivo com dados coletados por entrevista semiestruturada e analisados pelo programa Alceste. Resultados: A maior dificuldade de ênfase cognitiva e técnica foi a falta de treinamento; e de ênfase administrativa, foi a falta de recursos materiais e humanos. As bombas de infusão e sua utilização adequada foram destacadas como o recurso tecnológico que mais contribuiu para a segurança do paciente. Considerações finais: A falta de treinamento é apresentada como a maior dificuldade dos profissionais de Enfermagem e permeia as questões de segurança do paciente e do profissional ao utilizar as tecnologias duras na TIV. O treinamento é imprescindível para o desenvolvimento das técnicas, consideradas como ferramentas do fazer da Enfermagem.
Asunto(s)
Diseño de Equipo/normas , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/normas , Seguridad del Paciente/normas , Distribución de Chi-Cuadrado , Competencia Clínica/normas , Hospitales Universitarios/organización & administración , Humanos , Unidades de Cuidados Intensivos/organización & administración , Enfermeras y Enfermeros/normas , Investigación Cualitativa , Enseñanza/normasRESUMEN
ABSTRACT Objectives: To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Method: Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. Results: The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. Final considerations: The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools.
RESUMEN Objetivos: Identificar las dificultades del personal de enfermería en utilizar tecnologías durante la terapia intravenosa (TIV) y discutir las dificultades encontradas bajo el punto de vista de la seguridad del paciente. Método: estudio cualitativo, de tipo descriptivo, en el cual se empleó entrevista semiestructurada para la recolección de los datos y los analizó por el programa Alceste. Resultados: La dificultad de énfasis cognitiva y técnica más frecuente fue la ausencia de capacitación para utilizar la tecnología; y la de énfasis administrativa fue la ausencia de recursos materiales y humanos. El recurso tecnológico que más contribuye para garantizar la seguridad del paciente fue las bombas de infusión y su correcto empleo. Consideraciones finales: El personal de enfermería relató que la ausencia de capacitación es la dificultad que más enfrentan, y que les va a influir en la seguridad del paciente y del profesional al emplear las tecnologías en la TIV. Las capacitaciones son esenciales para el desarrollo de las técnicas, consideradas las herramientas de hacer enfermería.
RESUMO Objetivos: Identificar quais são as dificuldades da equipe de Enfermagem no manejo das tecnologias durante a terapia intravenosa (TIV) e discutir as dificuldades identificadas sob a perspectiva da segurança do paciente. Método: abordagem qualitativa, do tipo descritivo com dados coletados por entrevista semiestruturada e analisados pelo programa Alceste. Resultados: A maior dificuldade de ênfase cognitiva e técnica foi a falta de treinamento; e de ênfase administrativa, foi a falta de recursos materiais e humanos. As bombas de infusão e sua utilização adequada foram destacadas como o recurso tecnológico que mais contribuiu para a segurança do paciente. Considerações finais: A falta de treinamento é apresentada como a maior dificuldade dos profissionais de Enfermagem e permeia as questões de segurança do paciente e do profissional ao utilizar as tecnologias duras na TIV. O treinamento é imprescindível para o desenvolvimento das técnicas, consideradas como ferramentas do fazer da Enfermagem.
Asunto(s)
Humanos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/normas , Seguridad del Paciente/normas , Grupo de Enfermería/normas , Enseñanza/normas , Distribución de Chi-Cuadrado , Competencia Clínica/normas , Investigación Cualitativa , Hospitales Universitarios/organización & administración , Unidades de Cuidados Intensivos/organización & administración , Enfermeras y Enfermeros/normasRESUMEN
INTRODUCTION: Line type blood-liquid warmers are used widely due to their low expense, practical use and nondependence on sets. We aimed to investigate the relationship of bubbles in line type warmers with two different warming properties. MATERIALS AND METHODS: Two groups were designed with S-line and Astoflo® brand blood-liquid warmers. By using 10 medisets for each group (n = 20), we infused 1,000 mL 0.9% NaCl solutions at 350 mL.hour-1 speed for one hour in the operating room. Temperatures at the proximal, midway and distal parts of lines, temperature of experiment environment, temperature of liquid used and temperature of liquid reaching the cannula after warming were measured. Time to visually observable bubble formation was recorded. We compared findings statistically using the Mann-Whitney U test. RESULTS: There were no differences between the groups with respect to temperatures at the proximal, midway and distal parts of lines, temperature of experiment environment, temperature of liquid used and temperature of liquid reaching the cannula (p > 0.05). Bubbles were observed with both warmers and time to bubble formation was similar in the two study groups (p = 0.143). CONCLUSIONS: In the experimental setting, we have designed conditions similar to our clinical environment. Both types of warmers provided similar warming levels and formed visible bubbles. Considering that low amounts of emboli can be fatal in infants and children, bubble formation should be taken seriously into account for emboli and further studies should be carried out to determine the amount, the reasons and the contents of bubble formation.
Asunto(s)
Embolia Aérea/epidemiología , Embolia Aérea/etiología , Infusiones Intravenosas/instrumentación , Diseño de Equipo , Humanos , Infusiones Intravenosas/efectos adversos , Medición de Riesgo , TemperaturaRESUMEN
Adverse drug events resulting from errors in prescribing or administering medications are preventable. Within a hospital system, numerous technologies are employed to address the common sources of medication error, including the use of electronic medical records, physician order entry, smart infusion pumps, and barcode medication administration systems. Infusion safety is inherently risky because of the high-risk medications administered and the lack of integration among the stand-alone systems in most institutions. Intravenous clinical integration (IVCI) is a technology that connects electronic medical records, physician order entry, smart infusion pumps, and barcode medication administration systems. It combines the safety features of an automatically programmed infusion pump (drug, concentration, infusion rate, and patient weight, all auto-programmed into the device) with software that provides visibility to real-time clinical infusion data. Our article describes the characteristics of IVCI at WellSpan Health and its impact on patient safety. The integrated infusion system has the capability of reducing medication errors, improving patient care, reducing in-facility costs, and supporting asset management. It can enhance continuous quality improvement efforts and efficiency of clinical work flow. After implementing IVCI, the institution realized a safer patient environment and a more streamlined work flow for pharmacy and nursing.
Asunto(s)
Quimioterapia Asistida por Computador/economía , Bombas de Infusión , Infusiones Intravenosas/instrumentación , Errores de Medicación/prevención & control , Administración de la Seguridad/economía , Administración de la Seguridad/métodos , Prestación Integrada de Atención de Salud/organización & administración , Hospitales Comunitarios , Hospitales Filantrópicos , Humanos , Seguridad del Paciente , Pennsylvania , Programas Informáticos , Transferencia de TecnologíaRESUMEN
OBJECTIVE: Occupational risk of transmission of bloodborne pathogens represents a major challenge in prevention. Even though preventive recommendations to avoid needlestick injuries among healthcare workers include the use of needle protective devices, its use in developing countries is not a standard practice. This study aimed to measure, on experienced nurses, perception of performance characteristics and activation of the safety feature of a safety closed IV catheter system (BD Pegasus*), called catheter P, versus a non-safety device (BD Intima II ) called catheter I in healthy volunteers. METHOD: Fifty-two nurses and 205 healthy volunteers participated in a prospective, randomized, controlled study in a simulated setting. Each nurse performed two insertions of each catheter (one in each forearm) in four study volunteers; the order of insertions was randomly assigned. Statistical analyses were performed to compare the performance of the two catheters regarding Overall Perception of Clinical Acceptability and Ease of Use. RESULTS: Overall acceptance of the device performance characteristics was 90% or more. In all cases, catheter P performed at least as well as catheter I. There were no differences in the insertion success rate between the two devices (93.7% vs. 96.2%). Activation of the safety feature of catheter P occurred 99.4%. Subjects' perception of pain was similar for both devices. Overall perception of clinical acceptability and ease of use were judged better for catheter P than for catheter I (p = 0.006, and p < 0.001 respectively). All clinicians strongly agreed that catheter P would protect them from needle stick injuries. CONCLUSIONS: Despite the study limitations, mainly its artificial setting and its inability to blind, the results indicate that the Safety Closed IV Catheter System with its safety feature represents a good alternative for IV catheter insertions that can help reduce the incidence of stick injuries in health care workers.
Asunto(s)
Actitud del Personal de Salud , Cateterismo/instrumentación , Catéteres de Permanencia , Equipos de Seguridad/estadística & datos numéricos , Adulto , Anciano , Cateterismo/efectos adversos , Cateterismo/psicología , Catéteres de Permanencia/efectos adversos , Catéteres de Permanencia/estadística & datos numéricos , Femenino , Humanos , Infusiones Intravenosas/efectos adversos , Infusiones Intravenosas/instrumentación , Masculino , Persona de Mediana Edad , Lesiones por Pinchazo de Aguja/epidemiología , Lesiones por Pinchazo de Aguja/prevención & control , Enfermeras y Enfermeros/psicología , Exposición Profesional/prevención & control , Exposición Profesional/estadística & datos numéricos , Dimensión del Dolor/métodos , Dimensión del Dolor/estadística & datos numéricos , Percepción , Satisfacción Personal , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the impact of syringe size on start-up delay and the time to reach 50% and 90% of target flow rates, using two commercially available syringe infusion pumps at infusion rates of < or =1 mL/hr. DESIGN: Two syringes (Terumo) of different size (10-mL and 50-mL), using two syringe infusion pumps (Pump A, Terumo Terufusion Infusion Pump TE-331; and Pump B, Braun Perfusor Compact S) were studied. Effective fluid delivery was measured at 0.4 mL/hr, 0.8 mL/hr, and 1.0 mL/hr for the initial 60 mins, using the gravimetric method. Instant flow was calculated as volume difference for every 1-min interval per minute. Start-up delay was defined as time in minutes of 0 flow from the start of infusion. Syringe placement, bubble removal, infusion line priming, and positioning were standardized for all measurements, using new syringes and infusion lines. Each experiment was repeated six times. Statistical analysis was performed, using a nonparametric test (Mann-Whitney U test). SETTING: None. PATIENTS: None. INTERVENTIONS: None. RESULTS: Using the 50-mL syringe, the start-up delay was consistently higher and the time to reach 50% and 90% of target flow were significantly longer, independent of which syringe infusion pump was used. At every flow rate studied, the pumps did not reach the target flow rate before 60 mins with the 50-mL syringe. With the 10-mL syringe, target flow rate was achieved before 20 mins for both pumps. CONCLUSIONS: Our findings demonstrate a clinically relevant impact of syringe size on syringe infusion pump performance at low flow rates. The time to reach 50% and 90% of target flow are significantly longer, using the 50-mL syringe compared with the 10-mL syringe, and the time to reach 50% of target flow is independent of the longer start-up delay. Based on our findings, we speculate that smaller syringe sizes and higher infusion rates are preferable for continuous drug infusions, particularly when prompt establishment of the drug effect is critical.
Asunto(s)
Bombas de Infusión/normas , Jeringas , Diseño de Equipo , Humanos , Infusiones Intravenosas/instrumentaciónRESUMEN
OBJECTIVE: We sought to ascertain the effect of switching from an open infusion system to a closed system on rates and sequelae of central venous catheter (CVC)-associated bloodstream infection in the intensive care department (ICU) of 2 hospitals in Argentina. METHODS: A prospective, controlled, time-series, cohort trial was undertaken in adult patients admitted to 4 level-III adult ICUs in Buenos Aires, Argentina, who had a CVC in place for at least 24 hours. Rates of CVC-associated bloodstream infection during a period of active surveillance with an open system (baseline; externally vented, semirigid, noncollapsible, 1-port plastic bottles) were compared with rates after switching to a closed system (intervention; nonvented, collapsible, 2-port plastic bags). RESULTS: Between August 1999 and March 2002, 992 patients in the ICU with CVCs were enrolled. Patients during each study period (open system, 608; closed system, 384) were similar with respect to sex, severity-of-illness score, and prevalence of diabetes and cancer. Compliance with handwashing and CVC site care was also similar during the 2 study periods. The incidence of CVC-associated bacteremia during use of the closed system was significantly lower than during use of the open system (2.36 vs 6.52/1000 catheter-days, relative risk=0.36, 95% confidence interval=0.14-0.94, P=.02); bacteremias caused by gram-negative bacilli declined by 64%. In all, 17 patients with catheter-associated bacteremia died during the period when the open system was in use (2.8%), versus only 1 (0.2%) during use of the closed system (relative risk 0.09, P=.003). The calculated cost savings in the 20 hospital-month intervention period was $53,768 and 130.9 ICU days. CONCLUSION: Adoption of a closed infusion system resulted in major reductions in the incidence of catheter-associated bacteremia, related mortality, and cost. Because most Latin American hospitals still use externally vented fluid containers, switching to nonvented bags could substantially reduce rates of nosocomial bacteremia.
Asunto(s)
Bacteriemia/epidemiología , Bacteriemia/prevención & control , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Infusiones Intravenosas/efectos adversos , Anciano , Argentina/epidemiología , Bacteriemia/etiología , Bacteriemia/microbiología , Candida/aislamiento & purificación , Estudios de Cohortes , Infección Hospitalaria/etiología , Infección Hospitalaria/microbiología , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Humanos , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/métodos , Unidades de Cuidados Intensivos , Masculino , Prevalencia , Estudios Prospectivos , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVES: To determine the cause of an outbreak of Klebsiella pneumoniae bloodstream infections (BSIs) among neonates in a high-risk nursery and to institute control measures. DESIGN: During the on-site investigation, a cohort study to identify risk factors for K. pneumoniae BSI, a point-prevalence study to assess K. pneumoniae colonization, a maternal cohort study to determine maternal K. pneumoniae colonization, and an observational study to evaluate healthcare worker (HCW) compliance with infection control practices were conducted. PATIENTS AND SETTING: Neonates in a 40-bed high-risk nursery in a 700-bed university hospital in Cali, Colombia. INTERVENTION: Cohorting of neonates colonized with K. pneumoniae. RESULTS: The overall K. pneumoniae BSI attack rate was 10 of 105 (9.5%). In the retrospective cohort study, the number of blood transfusions (OR, 3.1 per transfusion; P = .02; CI95, 1.4-9.7) and intravenous injections (OR, 1.2 per injection; P = .04; CI95, 1.0-1.5) were independently associated with K. pneumoniae BSI. The overall prevalence of K. pneumoniae colonization was 61% among neonates and 7% among mothers. During the HCW assessment, suboptimal intravenous therapy practices were observed. A cohorting intervention resulted in a significant reduction in K. pneumoniae colonization (12% vs 61%; RR, 0.19; P < .001). During the intervention period, no K. pneumoniae BSIs occurred. CONCLUSIONS: This investigation suggested that the outbreak probably occurred due to widespread colonization and suboptimal infection control and intravenous therapy practices. Cohorting successfully reduced the overall prevalence of K. pneumoniae colonization and, along with improved infection control practices, probably prevented K. pneumoniae BSIs
Asunto(s)
Bacteriemia/etiología , Catéteres de Permanencia/microbiología , Infección Hospitalaria/microbiología , Contaminación de Equipos , Unidades de Cuidado Intensivo Neonatal , Infecciones por Klebsiella/etiología , Klebsiella pneumoniae/aislamiento & purificación , Bacteriemia/microbiología , Bacteriemia/prevención & control , Patógenos Transmitidos por la Sangre , Estudios de Cohortes , Colombia/epidemiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Brotes de Enfermedades/prevención & control , Femenino , Adhesión a Directriz , Hospitales Universitarios , Humanos , Recién Nacido , Control de Infecciones/métodos , Control de Infecciones/normas , Transmisión de Enfermedad Infecciosa de Profesional a Paciente , Infusiones Intravenosas/efectos adversos , Infusiones Intravenosas/instrumentación , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/prevención & control , MasculinoRESUMEN
OBJECTIVE: To assess the rate of bacterial contamination of intravenous administration sets at their rubber injection ports and matching infusates. DESIGN: Cultures of injection ports and infusate during 26 visits to 4 hospitals. SETTING: Four public general pediatric hospitals in Mexico City with substandard care practices. PATIENTS: Hospitalized pediatric patients receiving intravenous solutions. RESULTS: Overall, 176 of 251 injection ports were contaminated (70.1%; 95% confidence interval [CI95], 64.5% to 75.8%), 35 (13.9%; CI95, 9.7% to 18.2%) with gram-negative rods, primarily of the tribe Klebsielleae. Cultures of infusates were positive in 17 cases (6.8%, CI95, 3.7% to 9.9%), 5 of which grew gram-negative rods (2%; CI95, 0.6% to 4.6%). In 3 cases (1.2%), the same species with gram-negative rods was found in the infusates and on the injection ports. During one visit, 8 clustered cases of injection port contamination with a clonal Enterobacter cloacae were found; this agent was also found in the blood culture, intravenous fluid, and parenteral nutrition of one patient. Inadequate chlorination of tap water, a potential risk factor, was recorded during 22 visits (84.6%). CONCLUSION: These data suggest that external contamination of the intravenous administration set could play a role in infusate contamination.
Asunto(s)
Catéteres de Permanencia/microbiología , Infección Hospitalaria/microbiología , Contaminación de Equipos , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/etiología , Hospitales Pediátricos , Patógenos Transmitidos por la Sangre , Niño , Preescolar , Análisis por Conglomerados , Infección Hospitalaria/epidemiología , Países en Desarrollo , Brotes de Enfermedades/prevención & control , Electroforesis en Gel de Campo Pulsado , Femenino , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/prevención & control , Hospitales Públicos , Humanos , Lactante , Infusiones Intravenosas/efectos adversos , Infusiones Intravenosas/instrumentación , Masculino , México , Microbiología del AguaAsunto(s)
Infecciones por Acinetobacter/etiología , Infección Hospitalaria/etiología , Brotes de Enfermedades/estadística & datos numéricos , Contaminación de Equipos/estadística & datos numéricos , Fiebre/etiología , Infusiones Intravenosas/instrumentación , Infecciones Estafilocócicas/etiología , Infecciones por Acinetobacter/prevención & control , Brasil , Infección Hospitalaria/prevención & control , Brotes de Enfermedades/prevención & control , Contaminación de Equipos/prevención & control , Fiebre/prevención & control , Hospitales Urbanos , Humanos , Control de Infecciones/métodos , Infecciones Estafilocócicas/prevención & controlRESUMEN
1 case-controlled retrospective analysis compared the "two bag system," based on the euglycemic clamp technique, versus the traditional "one bag" method for intravenous diabetic ketoacidosis management. The two bag system can provide more cost-effective intravenous dextrose and fluid delivery and enhance quality of care by improving the efficiency, timeliness, and flexibility of overall control.
Asunto(s)
Cetoacidosis Diabética/terapia , Fluidoterapia/instrumentación , Glucosa/administración & dosificación , Adolescente , Estudios de Casos y Controles , Niño , Análisis Costo-Beneficio , Cetoacidosis Diabética/economía , Femenino , Fluidoterapia/economía , Fluidoterapia/estadística & datos numéricos , Humanos , Infusiones Intravenosas/economía , Infusiones Intravenosas/instrumentación , Infusiones Intravenosas/estadística & datos numéricos , Insulina/administración & dosificación , Masculino , Estudios RetrospectivosRESUMEN
We report two patients, an 82 years old female and a 71 years old male, who had a severe sepsis with positive blood cultures for Staphylococcus aureus and a superficial phlebitis as the only probable focus. In both the diagnosis of septic phlebitis was reached and an emergency phlebotomy was performed under local anesthesia. The clinical response was satisfactory and the pathological examination of excised veins showed an acute exudative leukocytic thrombophlebitis.
Asunto(s)
Infecciones Estafilocócicas/diagnóstico , Staphylococcus aureus/aislamiento & purificación , Tromboflebitis/microbiología , Anciano , Anciano de 80 o más Años , Catéteres de Permanencia/efectos adversos , Femenino , Humanos , Infusiones Intravenosas/efectos adversos , Infusiones Intravenosas/instrumentación , Masculino , Índice de Severidad de la Enfermedad , Tromboflebitis/diagnóstico , Tromboflebitis/etiología , Tromboflebitis/cirugíaRESUMEN
Means of vascular access are fundamental in the management of cancer. However, since current intravenous devices for long-term treatment are expensive and necessitate a high degree of education among medical personnel, in developing countries they are impractical for use in most of the population. We describe the use of a nontunneled, low-cost, long-lasting Silastic catheter (LLSC), cared for by an intravenous therapy team (IVTT), in 462 patients with cancer. The rate of infectious complications was 0.66 infections per 1,000 catheter-days, which is as low as that reported in association with other catheters in developed countries. Neutropenia and skin and/or soft-tissue infections were significant risk factors associated with LLSC-related infections. We believe that use of this catheter may be an alternative for patients with cancer who need chemotherapy, as long as an IVTT is established for its care. Our experience could be useful for practitioners in countries with similar socioeconomic characteristics.
Asunto(s)
Antineoplásicos/administración & dosificación , Catéteres de Permanencia , Infusiones Intravenosas/instrumentación , Elastómeros de Silicona , Países en Desarrollo , Humanos , Incidencia , Infecciones/epidemiología , Infecciones/etiología , Infusiones Intravenosas/economía , Tablas de Vida , México , Neoplasias/tratamiento farmacológico , Neoplasias/economía , Neutropenia/epidemiología , Neutropenia/etiología , Grupo de Atención al Paciente , Factores de RiesgoRESUMEN
Continuous insulin infusion is sometimes used in very low birth weight infants with glucose intolerance. We studied the availability of insulin to the neonate by means of a laboratory-simulated clinical infusion under both flushed and non-flushed conditions. Although loss of insulin was noted with both solutions (0.5 U/ml), under the nonflushed condition only 55.9% of the prescribed dose for the first 2 hours was delivered before the delivery rate of the flushed system, 71.4%, was approached. These findings have implications for neonatal insulin administration.
Asunto(s)
Infusiones Intravenosas/instrumentación , Insulina/administración & dosificación , Adsorción , Humanos , Hiperglucemia/tratamiento farmacológico , Recién Nacido , Infusiones Intravenosas/métodos , Insulina/farmacocinéticaRESUMEN
Needlestick injuries are a serious, but preventable problem in the healthcare industry. Industry has developed better devices to protect the healthcare worker. This study evaluates the impact of a "needleless" intravenous system on needlestick exposures and whether the increased cost of this new system could be justified. Exposures were defined and injury reports analyzed retrospectively and following introduction of the needleless IV system. This study indicates that the introduction of a needleless IV system can significantly reduce the number of IV-related injuries that occur in an institution, and is economically feasible. Other categories of exposure (needle-related, related to other sharps, and trash-related) also showed a drop, whereas exposure from the disposal of sharp devices into needle boxes showed a significant increase. This seems to support other findings that in-room needle-box containers have not thus far reduced the number of injuries related to sharps disposal.
Asunto(s)
Infusiones Intravenosas/instrumentación , Lesiones por Pinchazo de Aguja/epidemiología , Exposición Profesional/estadística & datos numéricos , Personal de Hospital/estadística & datos numéricos , Costos y Análisis de Costo , Estudios de Evaluación como Asunto , Hospitales con más de 500 Camas , Hospitales Universitarios , Humanos , Control de Infecciones/economía , Control de Infecciones/métodos , Infusiones Intravenosas/economía , Infusiones Intravenosas/métodos , Lesiones por Pinchazo de Aguja/clasificación , Lesiones por Pinchazo de Aguja/prevención & control , Pennsylvania/epidemiología , Eliminación de ResiduosRESUMEN
Presentamos nuestras experiencias acumuladas desde enero de 1988 hasta marzo de 1991 en el Hospital ABC con el manejo de 151 pacientes (54.3 por ciento mujeres y 45.69 por ciento varones), que requirieron de 153 accesos vasculares temporales con catéteres de hule siliconizado (Hickman 9.6 Fr. 71.2 por ciento, Broviac 6.6 Fr. 24.83 por ciento y Hickman 9.0 Fr. 3.9 por ciento). Su indicación fue quimioterapia en el 76.15 por ciento, antibioticoterapia en el 19.20 por ciento y nutrición parenteral en el 4.63 por ciento. Se colocaron con técnica percutánea (97 por ciento) o por venodisección (2.66 por ciento). El tiempo de seguimiento fue de un día a 20 meses (promedio 4.82 meses).Morbilidad: complicaciones intraoperatorias 3.26 por ciento, postoperatorias 15.83 por ciento. Mortalidad: operatoria 0.66 por ciento, no operatoria 32.45 por ciento. El empleo se accesos vasculares temporales con catéteres de hule siliconizado fue de gran ayuda en el manejo de estos enfermos.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Administración Cutánea , Cateterismo Venoso Central/estadística & datos numéricos , Quimioterapia , Infusiones Intravenosas/instrumentación , Infusiones Parenterales/instrumentación , Venas Yugulares/cirugía , Nutrición Parenteral/instrumentación , Punciones/estadística & datos numéricos , Vena Subclavia/cirugía , Vena Cava Inferior/cirugía , Vena Cava Superior/cirugía , VenodisecciónRESUMEN
As autoras apresentam um método de ensino por elas testado, implantado e atualmente utilizado nas aulas práticas dos procedimentos de punçäo venosa, ministraçäo de medicamentos por via endovenosa e infusäo intravenosa, para alunos das disciplinas Introduçäo à Enfermagem e Introduçäo à Prática Hospitalar dos cursos de Graduaçäo em Enfermagem e Obstetrícia e de Medicina, respectivamente, na Universidade Federal de Mato Grosso. Descrevem a instalaçäo do sistema que simula uma veia e relacionam o material para sua construçäo. Destacam a importância do laboratório de simulaçäo do procedimento e concluem que a utilizaçäo desse sistema tem sido uma excelente forma para o ensino dos mesmos.
Asunto(s)
Infusiones Intravenosas/instrumentación , Educación en Enfermería/métodos , Punciones , Infusiones IntravenosasRESUMEN
With the purpose of finding the most economical method to administer intravenous fluids, we studied 3 groups of children with different pathologies: 50 cases with peripheral intravenous lines (PIL), 50 with venesection (VD) and 50 with percutaneous silastic catheter (PC). To facilitate the cost-expense analysis, each procedure was standardized to a "PIL unit". We found that PIL is the less expensive when IV fluids are administered for over periods of less than 5 days; even though we had an index failure of 24%. The PC has a low cost easy to place and with the advantage that can be established centrally for the measurement of central venous pressure, administration of hypertonic solutions or total parenteral nutrition. Preserving the vascular lumen when it is withdrawn, and resulting as an ideal method when administering fluids for for more than 5 days. VD must be left as a last resource, given its cost and because generally this ruins permanently the vein employed. Complications observed in the 3 procedures were similar to those reported by other authors and there were no mayor complications observed in this study.
Asunto(s)
Venodisección , Cateterismo Venoso Central , Infusiones Intravenosas , Adolescente , Venodisección/efectos adversos , Venodisección/economía , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/economía , Niño , Preescolar , Análisis Costo-Beneficio , Humanos , Lactante , Infusiones Intravenosas/efectos adversos , Infusiones Intravenosas/economía , Infusiones Intravenosas/instrumentación , Nutrición Parenteral/instrumentación , Estudios Prospectivos , Elastómeros de SiliconaRESUMEN
È de amplo conhecimento que os procedimentos de administração medicamentosa é prerrogativa da enfermagem. Sendo assim, este estudo buscou identificar o conhecimento dos profissionais de enfermagem das unidades pediátricas...(AU)