Neonatal Nurse Practitioner Use of Ultrasonography to Verify Umbilical Venous Catheter Placement in the Neonatal Intensive Care Unit.
Adv Neonatal Care
; 20(4): 294-300, 2020 Aug.
Article
en En
| MEDLINE
| ID: mdl-32735412
BACKGROUND: Literature dating back to 1982 supports the use of ultrasound to confirm UVC position as a more reliable method compared to x-ray. The use of ultrasound to confirm UVC position remains infrequent in the NICU. PURPOSE: To determine the feasibility of training an NNP in the acquisition and interpretation of a parasternal short-axis (PSAX) image of the heart to confirm UVC position. METHODS: A retrospective review of 48 charts evaluated descriptive data using standard technique of an x-ray to confirm UVC placement. An NNP was trained to acquire and interpret a parasternal short-axis (PSAX) cardiac view by a pediatric cardiologist. The NNP independently and prospectively evaluated 21 neonates and determined whether the UVC was in satisfactory or unsatisfactory position. The same image was blindly over-read by the pediatric cardiologist. Agreement between the NNP and pediatric cardiologist interpretations as well as the pediatric cardiologist and radiologist interpretations was evaluated using the κ-test. RESULTS: Initial pediatric cardiology interpretation of UVC position showed the UVC to be malpositioned in 66% of neonates (n = 14). NNP and pediatric cardiology interpretations in UVC position had 86% agreement (κ-0.667). Pediatric cardiology (ultrasound) and radiology interpretations (x-ray) in UVC position had 86% agreement (κ-0.69). IMPLICATIONS FOR PRACTICE: It is feasible to train NNPs to perform and accurately interpret a single PSAX ultrasound image to determine satisfactory UVC position. IMPLICATIONS FOR RESEARCH: Increasing the use of ultrasound to determine satisfactory position of UVCs in the NICU can reduce unnecessary exposure to ionizing radiation in neonates.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cateterismo Periférico
/
Ultrasonografía
/
Enfermería Neonatal
/
Profesionales de Enfermería Pediátrica
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Humans
/
Newborn
Idioma:
En
Revista:
Adv Neonatal Care
Asunto de la revista:
PERINATOLOGIA
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Estados Unidos