Effect of Catheter Tunnelling and a Nutrition Nurse on Catheter Sepsis During Parenteral Nutrition

Keohane, P.P.; Attrill, H.; Northover, Jordan; Jones, Barry; Cribb, A.R.; Fröst, Peter; Silk, D. B. A.

doi:10.1016/s0140-6736(83)90922-4

Cited by 178 publications

(38 citation statements)

References 7 publications

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“…Venous access can be considered a routine matter, but it can carry serious complications, which can be maintained at a very low level if strict adherence to a regimented protocol of surgical technique and of catheter care is maintained. 90 In the early years of vascular access care, 91 it was shown that the most significant way to reduce catheter-related infections was rigorous aseptic nursing care, renewal of the dressings, and access to the catheter being the sole responsibility of specially trained nurses.…”

Section: Catheter Managementmentioning

confidence: 99%

Vascular Access in Oncology Patients

Gallieni

Pittiruti

Biffi

2008

CA: A Cancer Journal for Clinicians

253

166

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Adequate vascular access is of paramount importance in oncology patients. It is important in the initial phase of surgical treatment or chemotherapy, as well as in the chronic management of advanced cancer and in the palliative care setting. We present an overview of the available vascular access devices and of the most relevant issues regarding insertion and management of vascular access. Particular emphasis is given to the use of ultrasound guidance as the preferred technique of insertion, which has dramatically decreased insertion-related complications. Vascular access management has considerably improved after the publication of effective guidelines for the appropriate nursing of the vascular device, which has reduced the risk of late complications, such as catheter-related bloodstream infection. However, many areas of clinical practice are still lacking an evidence-based background, such as the choice of the most appropriate vascular access device in each clinical situation, as well as prevention and treatment of thrombosis. We suggest an approach to the choice of the most appropriate vascular access device for the oncology patient, based on the literature available to date. (CA Cancer J Clin 2008;58:323-346.)

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Section: Catheter Managementmentioning

confidence: 99%

Vascular Access in Oncology Patients

Gallieni

Pittiruti

Biffi

2008

CA: A Cancer Journal for Clinicians

253

166

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“…CVAD care might be judged a simple procedure, but if strict adherence to guidelines recommendations is not adopted it can lead to even life-threatening harms [44] . In the early years of CVAD, it was shown that the most significant actions to reduce CRBSIs were accurate aseptic care during replace of the dressing and access to the catheter reserved only to specially trained nurses [77] . Nowadays, worldwide registered nurses play a fundamental role in evaluating the need of a VAD in each patient and in preserving the functionality of the device [78] .…”

Section: Care Of the Vadmentioning

confidence: 99%

Focus on peripherally inserted central catheters in critically ill patients

Cotogni

Pittiruti

2014

WJCCM

105

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Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings (emergency, intensive care, surgery) and for different purposes (fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device (CVAD) (mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe -due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and pH solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as well as the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs (i.e. , low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD (CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care. 80November 4, 2014|Volume 3|Issue 4| WJCCM|www.wjgnet.com access devices (CVADs) are key elements of management for either adult or pediatric critically ill patients. Healthcare pro...

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“…Kateter bakımının düzenli ve doğru bir şekilde yapılması durumunda kateter ilişkili enfeksiyon oranının azaldığını gösteren çalışmalar mevcuttur. 9,24,26,38 Ça-lışmamızda hemşirelerin %30,7 (n=31)'sinin kateter pansumanının ne zaman yapılması gerektiği konusunda bilgi sahibi olduğu belirlenmiştir. Kurumumuzda yazılı protokollerin ve rehberlerin olmayışı bu duruma neden olarak gösterilebilir.…”

Section: Tartişma Ve Sonuçunclassified

“…tarafından yapılan çalışmada, ekibe hemşi-relerin de dâhil edilmesiyle katetere bağlı görülen enfeksiyon oranının %33'ten %4'e düştüğü gö-rülmüştür. 26 TPN tedavisi uygulanan hastalar aynı zamanda intravenöz (IV) ilaç tedavisi de almaktadırlar. Bu ilaçlar TPN tedavisinin uygulandığı damar yolundan verildiği takdirde uyumsuzluk gösterebilir ve tedavinin etkinliğini azaltır.…”

unclassified

Determination of the Level of Knowledge of Nurses Working at an Education Hospital About Total Parenteral Nutrition

Kalender¹,

Tosun²,

Kılıç³

2015

Turkiye Klinikleri J Nurs

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Ö ÖZ ZE ET T A Am ma aç ç: : Total parenteral nutrisyon (TPN), oral ya da enteral yolla yeterince beslenemeyen hastalar için kullanılan destek tedavi yöntemidir. TPN tedavisi, teorik ve pratik bilgi birikimi bulunan özel eğitim görmüş personel tarafından uygulanmalıdır. Ancak kliniklerde TPN konusunda özel eğitim almamış hemşireler tarafından da uygulanabilmektedir. Bu araştırma, bir eğitim hastanesinde çalışan hemşirelerin TPN konusundaki bilgi düzey-lerinin belirlenmesi amacıyla tanımlayıcı olarak yapılmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Hastanede çalışan hemşire sayısı 660 olup, çocuk hastalıkları ve çocuk cerrahisi klinikleri dışında hastanede çalışan tüm hemşireler (n=620) araştırmanın evrenini oluşturmuştur. Katılımcılara, araştırmacı tarafından geliştirilen hemşirelerin sosyodemografik özellikleri ve eğitim durumunu değerlendiren soru formu ile TPN'ye ilişkin bilgi düzeyini ölçen 40 soruluk anket uygulanmıştır. İstatistikçi görüşü ve literatürdeki benzer bir çalışmanın değerlendirme kriterleri doğrultusunda 75 ve üzeri puan alanlar yeterli olarak kabul edilmiştir. Araştırma tanımlayıcı bir çalışma olup, Temmuz-Ağustos 2012 tarihleri arasında yürütülmüştür. B Bu ul lg gu ul la ar r: : TPN konusunda hemşirelerin bilgi düzeyi düşük bulunmuştur. Araştırmaya katılan hemşirelerin TPN tedavisinin ne zaman uygulanacağı, kullanılan solüs-yonların özellikleri ve hastanın tedavi süresince takibinin yapılması gerektiği konularında yeterli bilgiye sahip olduğu görülmüştür. TPN tedavisi uygulanan hastaların vital bulgularının takip sıklığı, tedavinin santral venöz kateter aracılığıyla uygulanması durumunda kateter pansumanının değişim sıklığı ve hastanın yeteri kadar beslenip beslenmediğinin takibini yapmak için kullanılacak yöntemler hakkında ise yeterince bilgi sahibi olmadıkları görülmüştür. Son iki yılda bilimsel makale/kitap okuma durumu ile bilgi düzeyi arasında fark bulunmuştur. S So on nu uç ç: : Hemşirelerin TPN tedavisi uygulanan hastaların kateter bakımı ve tedavinin etkinliğinin değerlendirilmesi konularında bilgi eksiklikleri olduğu sonucuna varılmıştır. TPN tedavisi uygulanan hastalara daha etkili bakım verebilmek için bilgi eksikliği bulunan alanlara yönelik hemşirelere eğitim verilmesi, yazılı protokoller oluşturulması ve belirli aralıklarla güncellenmesi önerilmiştir.A An na ah ht ta ar r K Ke el li im me el le er r: : Hemşireler; parenteral beslenme, total; bilgi A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Total parenteral nutrition (TPN) is a supportive treatment technique for patients who can not be fed enough orally or enterally. TPN treatment should be applied by specially trained personnel who had adequate theoretical and practical knowledge. However, TPN can be administered by nurses who have no special training. This research was performed as descriptive for determination of the level of knowledge (about total parenteral nutrition) of nurses working at an education hospital. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The number of nurses wh...

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Effect of Catheter Tunnelling and a Nutrition Nurse on Catheter Sepsis During Parenteral Nutrition

Cited by 178 publications

References 7 publications

Vascular Access in Oncology Patients

Vascular Access in Oncology Patients

Focus on peripherally inserted central catheters in critically ill patients

Determination of the Level of Knowledge of Nurses Working at an Education Hospital About Total Parenteral Nutrition

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