Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial

Chan, Raymond Javan; Northfield, Sarah; Larsen, Emily; Mihala, Gabor; Ullman, Amanda; Hancock, Peter A.; Marsh, Nicole; Gavin, Nicole; Wyld, David; Allworth, Anthony; Russell, Emily; Choudhury, Abu; Flynn, Julie; Rickard, Claire M

doi:10.1186/s13063-017-2207-x

Cited by 51 publications

(66 citation statements)

References 36 publications

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“…Original research 25% of central venous catheters [4][5][6] fail prior to treatment completion. High failure rates and associated complications have been recognised internationally for their contribution to patient harm and increased healthcare expenditure.…”

Section: Introductionmentioning

confidence: 99%

International recommendations for a vascular access minimum dataset: a Delphi consensus-building study

et al. 2020

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BackgroundData regarding vascular access device use and outcomes are limited. In part, this gap reflects the absence of guidance on what variables should be collected to assess patient outcomes. We sought to derive international consensus on a vascular access minimum dataset.MethodsA modified Delphi study with three rounds (two electronic surveys and a face-to-face consensus panel) was conducted involving international vascular access specialists. In Rounds 1 and 2, electronic surveys were distributed to healthcare professionals specialising in vascular access. Survey respondents were asked to rate the importance of variables, feasibility of data collection and acceptability of items, definitions and response options. In Round 3, a purposive expert panel met to review Round 1 and 2 ratings and reach consensus (defined as ≥70% agreement) on the final items to be included in a minimum dataset for vascular access devices.ResultsA total of 64 of 225 interdisciplinary healthcare professionals from 11 countries responded to Round 1 and 2 surveys (response rate of 34% and 29%, respectively). From the original 52 items, 50 items across five domains emerged from the Delphi procedure.Items related to demographic and clinical characteristics (n=5; eg, age), device characteristics (n=5; eg, device type), insertion (n=16; eg, indication), management (n=9; eg, dressing and securement), and complication and removal (n=15, eg, occlusion) were identified as requirements for a minimum dataset to track and evaluate vascular access device use and outcomes.ConclusionWe developed and internally validated a minimum dataset for vascular access device research. This study generated new knowledge to enable healthcare systems to collect relevant, useful and meaningful vascular access data. Use of this standardised approach can help benchmark clinical practice and target improvements worldwide.

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Section: Introductionmentioning

confidence: 99%

International recommendations for a vascular access minimum dataset: a Delphi consensus-building study

et al. 2020

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“…There is growing evidence on the effectiveness of tissue adhesive, or medical-grade superglue, to secure, prevent infection, and promote function of vascular access devices (Bugden et al, 2016, Chan et al, 2017, Edwards et al, 2014. Our data demonstrates that tissue adhesive is associated with increased risk of itch (peripheral devices; HR 6.92) and mechanical skin tears (central devices; HR >100).…”

Section: Discussionmentioning

confidence: 99%

“…The identification of risk factors can then be used to support the development of innovative interventions for appropriate patient groups, to prevent and treat these complications and ensure the efficient use of health resources. Types of studies: Data were extracted from 12 randomised controlled trials (Bugden et al, 2016, Chan et al, 2017, Edwards et al, 2014, Rickard et al, 2012, Webster et al, 2017 and one prospective cohort study completed by the Alliance for Vascular Access Teaching and Research group, and combined into a single database for analysis. The individual studies examined the efficacy of vascular access dressing and securement products (Bugden et al, 2016, Chan et al, 2017, Edwards et al, 2014, Webster et al, 2017, evaluated the effectiveness of routine peripheral vascular access device replacement (Rickard et al, 2012), and observed vascular access-associated management and outcomes .…”

Section: Introductionmentioning

confidence: 99%

Skin complications associated with vascular access devices: A secondary analysis of 13 studies involving 10,859 devices

Ullman

Mihala

O’Leary

et al. 2019

International Journal of Nursing Studies

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Background: Vascular access devices are widely used in healthcare settings worldwide. The insertion of a vascular access device creates a wound, vulnerable to irritation, injury and infection. Vascular access-associated skin complications are frequently reported in the literature, however very little evidence is available regarding the incidence and risk factors of these conditions to inform practice and technology development. Objectives: To estimate the incidence of vascular access-associated skin complications, and to identify patient, catheter and healthcare-related characteristics associated with skin complication development. Design: Secondary data analysis from 13 multi-centre randomised controlled trials and observational studies evaluating technologies and performance of vascular access devices in clinical settings between 2008 and 2017. Settings: Six hospitals (metropolitan and regional) in Queensland, Australia. Participants: The 13 studies involved paediatric and adult participants, across oncology, emergency, intensive care, and general hospital settings. A total of 7,669 participants with 10,859 devices were included, involving peripheral venous (n=9,933), peripheral arterial (n=341), and central venous access (n=585) devices. Analysis: Standardised study data were extracted into a single database. Clinical and demographic data were descriptively reported. Cox proportional hazards regression models (stratified by peripheral vs central) were used for time-to-event, per-device analyses to examine risk factors. Univariate associations were undertaken due to complexities with missing data in both outcomes and covariates, with p<0.01 to reduce the effect of multiple comparisons. Results: Over 12% of devices were associated with skin complication, at 46.2 per 1,000 catheter days for peripheral venous and arterial devices (95% confidence interval, CI 42.1-50.7), and 22.5 per 1,000 catheter days for central devices (95% CI 16.5-306). The most common skin complications were bruising (peripheral n=134, 3.7%; central n= 33, 6.8%), and swelling due to infiltration for peripheral devices (n=296; 2.9%), and dermatitis for central devices (n=13; 2.2%). The significant risk factors for these complications were predominantly related to device (e.g., skin tears associated with peripheral arterial catheters [hazard ratio, HR 16.0], radial insertion [HR 18.0] basilic insertion [HR 26.0])) and patient characteristics (e.g., poor skin integrity associated with increased risk of peripheral device bruising [HR 4.12], infiltration [HR 1.98], and skin tear [HR 48.4]), rather than management approaches.

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“…The trial by Chan et al [68] compared standard care with 3 innovative dressing and securement methods in 121 adult patients receiving acute care. Their findings also showed that securement devices combined with dressings are superior to standard care alone in terms of CRBSI, the catheter failure rate, product costs, and patient and staff satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Dang¹,

Li²,

Tian³

2019

Medicine

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Purpose: The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related blood infections (CRBSI) and rank these antimicrobial dressings for practical consideration. Methods: We searched the PubMed, Cochrane library, Embase, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared dressings for prevention of CRBSI. Two authors independently extracted data from each included RCT according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the WinBUGS (V.1.4.3) and the Stata (V.15.0). Results: Finally, 35 RCTs involving 8494 patients and evaluating 13 dressings were included. Network meta-analysis showed that transparent dressing may be the best way to prevent CRBSI. Suture and bordered polyurethane dressing might have the lowest risk of CRBSI rate per 1000 catheter-days, and sutureless securement device might lead to the lowest incidence of catheter failure. Conclusions: This network meta-analysis indicated that transparent dressings may be selected for the prevention of CRBSI in patients with central venous catheters, which is of importance in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used dressings in this field.

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Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial

Cited by 51 publications

References 36 publications

International recommendations for a vascular access minimum dataset: a Delphi consensus-building study

International recommendations for a vascular access minimum dataset: a Delphi consensus-building study

Skin complications associated with vascular access devices: A secondary analysis of 13 studies involving 10,859 devices

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

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