Improving outcomes of short peripheral vascular access in oncology and chemotherapy administration

Abstract

A short peripheral intravenous catheter or cannula (PIVC) is frequently used to deliver chemotherapy in oncology practice. Although safe and easy to insert, PIVCs do fail, leading to personal discomfort for patients and adding substantially to treatment costs. As the procedure of peripheral catheterization is invasive, there is a need for greater consistency in the choice, insertion and management of short PIVCs, particularly in the oncology setting where there is a growing trend for patients to receive many different courses of IV treatment over a number of years, sometimes with only short remissions. This article reviews best practice with respect to PIVCs in cancer patients and considers the necessity for bundling these actions. Two care bundles, addressing both insertion and ongoing care and maintenance, are proposed. These have the potential to improve outcomes with the use of short PIVCs for vascular access in oncology practice.

Effectiveness of insertion and maintenance bundles in preventing peripheral intravenous catheter-related complications and bloodstream infection in hospital patients: A systematic review

“…Aziz, 2009, UK [41] Missing outcomes data; no complications or PIVC related infection data provided. Bertoglio, 2017, Italy [8] Review paper; not an intervention study. Boyd, 2011, UK [9] Missing outcomes data; no patient outcomes data provided.…”

“…Infection prevention measures in CVAD bundles include hand hygiene, optimal insertion site selection, maximal sterile barriers for line insertion, chlorhexidine skin disinfection, and daily review of device necessity with prompt removal of unneeded lines [5]. With the reported success of CVAD bundles, PIVC insertion and maintenance bundles are being implemented in many hospitals [8,9]. While compliance with CVAD bundles has resulted in BSI reductions in adult intensive care units (ICU), the impact of PIVC insertion and maintenance bundles is unclear.…”

ECO-SEOM-SEEO safety recommendations guideline for cancer patients receiving intravenous therapy

“…According to the available studies, complications associated with the use of peripheral catheters occur in around 35-50% of cases before the end of the expected time of use, so it is recommended to replace them after 72-96 h [5]. However, in patients who remain hospitalized there is increasing evidence in favor of withdrawing them by clinical indication, i.e.…”

“…Central venous catheters (CVCs) are used for various purposes, such as infusion of medicines and blood derivatives, hemodialysis, blood sampling, and hemodynamic monitoring, and can remain implanted for weeks and even years. The choice of central catheter type for each situation should be based on criteria such as duration of treatment, patient characteristics, infusion type and device characteristics, with duration of implantation being one of the most important factors [5]. To this end, although there is no clear definition of what should be considered short-or long-term, a recent study sets the limit at 30 days [7], which allows recommendations to be made to use PICCs for durations of implantation shorter than this period and tunneled catheters or PICCs for longer durations of implantation [11].…”

Bundle para manuseio do cateter central de inserção periférica em neonatos

“…(10) The bundle is a set of specific care and, when used together, provide significant improvement in health care. (11)(12)(13) This is a light technology proposed by the Institute for Healthcare Improvement, (14) which has since been used to prevent various aggravations. (8,(15)(16)(17)(18) As protocols, guidelines and checklists, the bundles are tools developed by experts, based on best evidence for safer practice of health and its use provides reduction of adverse events.…”