Object: Determine the cause of nosocomial cluster infections of peripheral venous catheter-related bloodstream infection (PIVC-BSI), and provide advice on prevention, control and nursing measures. Method: A retrospective analysis of nosocomial cluster infections that occurred in a tertiary hospital on July 28-30, 2019. Blood samples from patients suspected of PIVC-BSI were retained for bacterial culture. The clinical data of the patients, environmental hygiene indicators were collected. Results: All 8 patients had chills within 0.5 -3.5 hours after intravenous infusion, and the highest body temperature reached 41°C. The peripheral blood samples of 4 patients were cultured as Burkholderia cepacia infection, and the eluate from the catheter tip of 2 patients cultured the same bacteria as the blood culture. The humidity in the treatment preparation room was 60% -80%. There was mold in the sterile storage cabinet. Conclusion: The nosocomial cluster infection of PIVC-BSI was caused by Burkholderia cepacia colonizing the tip of the peripheral intravenous catheter, and the high air humidity was the most likely factor. The ability of nurses to identify and respond to PIVC-BSI as well as the infection control management level of each department still needs to be improved.
Background: PIVC therapy is the most common hospital procedure. Its insertion and maintenance are easy to fail.Objective: To investigate the current application of peripheral venous catheter (PIVC) in the department of hepatobiliary surgery and the risk factors that lead to indwelling failure. Peripheral intravenous catheter therapy is one of the most common treatment procedures but has a relatively high failure rate during insertion and indwelling. Methods: A cross-sectional correlation study was adopted. Clinical data of patients receiving PIVC from March to June in 2019 in our hospital were collected. All patients were inserted with closed 24G IV catheters manufactured by BD Company, sealed with 50U/mL heparin saline and secured by 3M Tegaderm Film-Transparent film dressing. Estuation caused by any reasons within 72 hours that failed to complete the treatment was considered to be indwelling failure. Univariate analysis was performed to analyze the effect of gender and age on the indwelling time, and logistic regression was used to analyze the related factors of indwelling needle-induced complications. The methods were consistent with the STROBE criteria (Supplementary File 1). Results: 445 patients were enrolled and clinical data from 395 patients were analyzed eventually, with a total of 773 PIVC cases. The indwelling time varied from 0.5h to 329h (median time 49.00±0.86h). Indwelling site: back of the hand (61%), forearm (28%), joint (6%), upper arm (4%) and finger (1%). The success rate of one-time puncture was 92%. PIVC indwelling failure rate was 46% which appeared to be higher in females and older people. Complications included exudation (72%), phlebitis (8%), blockage (5%) and errhysis (4%). There were no statistically significant differences in the incidence of complications in each indwelling period (P>0.05). Logistic regression analysis showed that complications were independent risk factors for catheter indwelling failure (OR: 26.98, P<0.01). Conclusions: PIVC mostly performed on the back of the hand and its indwelling time was associated with patients' gender and age in the department of hepatobiliary surgery. The occurrence of complications was an independent factor for PIVC failure.
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