RESUMO
BACKGROUND: There are controversies regarding the best way to collect blood samples for cyclosporine A (CsA) serum levels when this immunosuppressant is administered continuously through a silicone central venous catheter (CVC) to hematopoietic stem cell transplant recipients. OBJECTIVE: The aim of this study was to verify the effect of the time elapsed between the interruption of a continuous intravenous CsA infusion and the collection of blood samples on CsA serum levels. METHODS: This randomized 2-group clinical trial involved 32 adults. In group A, blood samples were collected immediately after interrupting the medication from peripheral vein and CVC lines. In group B, the same procedures were performed 5 minutes after interrupting the infusion. RESULTS: We did not observe influence of the time elapsed between interruption of the infusion and collection of the samples, independent of the collection mode and the volume discarded (P > .05). The line used for the infusion maintained a constant high level when compared with different moments of collection (P > .05), whereas in the other lines, there was a significant increase when compared with the levels obtained at 24 hours and 7 days after CsA start (P = .00). CONCLUSION: The CVC line free from cyclosporine can safely be used to collect blood. The procedure can be performed immediately after interrupting the infusion, and discarding 5 mL is sufficient to obtain accurate levels. IMPLICATIONS FOR PRACTICE: The results can help nurses choose how to collect blood samples through the CVC, thus preventing patients from having a painful and stressful procedure such as peripheral venipuncture.
Assuntos
Coleta de Amostras Sanguíneas/métodos , Ciclosporina/sangue , Adolescente , Adulto , Coleta de Amostras Sanguíneas/enfermagem , Cateteres Venosos Centrais , Ciclosporina/administração & dosagem , Feminino , Transplante de Células-Tronco Hematopoéticas , Humanos , Imunossupressores/administração & dosagem , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto JovemRESUMO
La obtencion de muestras sanguineas es un procedimiento que debe estar controlado y correctamente realizado tanto en su obtencion, conservacion,analisis e informe. La extraccion es una actividad del enfermero profesional junto al comite de control de infecciones y el servicio de bacteriologia clinica. Este protocolo tiene como objetivo central la revision y actualizacion de la sistematizacion de cuidados par la toma de muestra de hemocultivo de todo paciente adulto que ingresa a la institucion asegurando la obtencion de una muestra fiable
Assuntos
Humanos , Enfermagem , Coleta de Amostras Sanguíneas/enfermagem , Coleta de Amostras Sanguíneas/normasRESUMO
La obtencion de muestras sanguineas es un procedimiento que debe estar controlado y correctamente realizado tanto en su obtencion, conservacion,analisis e informe. La extraccion es una actividad del enfermero profesional junto al comite de control de infecciones y el servicio de bacteriologia clinica. Este protocolo tiene como objetivo central la revision y actualizacion de la sistematizacion de cuidados par la toma de muestra de hemocultivo de todo paciente adulto que ingresa a la institucion asegurando la obtencion de una muestra fiable
Assuntos
Humanos , Coleta de Amostras Sanguíneas/enfermagem , Coleta de Amostras Sanguíneas/normas , EnfermagemRESUMO
The members of the Nursing Team are submitted, many times, to posture attacks either due to the own requirement of the action or the utilization of improper corporeal posture during its execution. The present study aims at inquiring the type, length, frequency and posture changes adopted by the members of the Nursing Team during the execution of blood collection techniques, administering of intravenous medication and serotherapy. Through direct observation were recorded 10 activities corresponding to each one of the mentioned techniques, realized in attendance of patients from a University Hospital internment unit. The results evidenced that blood collection activity was 50, 35% effectuated in the inclined standing position, followed by the standing straight position, 49, 64%. Intravenous medication administering was executed with frequent adoption of the standing straight posture, 51, 09% (in special with the arm in frontal expansion), 45, 74% in the inclined standing position and 3, 15% seated. Serotherapy technique was executed with predominant adoption of standing position (86, 88%) in special with the arms in frontal expansion and 13, 11% in the inclined standing position. The unnecessary adoption, many times, of inclined standing posture indicates that Nursing personnel have been making possible the happening of spinal column attacks mainly due to the bad utilization of corporeal mechanic. The authors suggest more attention to these aspects, mainly at Nursing courses.