Nurses' Short Peripheral Catheter Flushing Practices: Implications for Patient Care, Nursing Education, and Policy

Norton, Crystal B; Lauria, Heather Alico; Baker, David; Hauser, Paloma; Smith-Miller, Cheryl A.

doi:10.1097/nan.0000000000000337

Cited by 6 publications

(19 citation statements)

References 22 publications

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“…In this experiment, we did not study the effect of the method of flush administration because we studied the effect of whether or not to perform the flush and the dose of flush administered after lipid emulsion administration. As a limitation of this experiment, it was also clear that the flush was performed manually and thus was greatly influenced by the individual's technique, which is similar to the report that the flushing technique is influenced by the nurse's experience and workload 7 .…”

Section: Discussionsupporting

confidence: 77%

“…On the other hand, in Japan, the dosage of flushes varies among medical institutions, and the Guidelines for Parenteral and Enteral Nutrition [1] do not provide any explanation or rationale for whether or not flushes should be performed in the line after lipid emulsion administration, which is an issue. Therefore, at present, whether to flush or not, or the dose of flush administered, tends to be influenced by the experience of nurses, as the report [7].…”

Section: Discussionmentioning

confidence: 99%

“…There are some reports about improper handling of catheters as one of the causes of CRBSI 6 , 7 , 8 . Conversely, a closed-type infusion device, which is easy to operate for the simultaneous administration of multiple drugs, is used broadly in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Microbial growth and importance of flushing inside closed-type infusion devices during administration of lipid emulsion in vitro setting

Omotani¹,

Hatsuda²,

Katsui³

et al. 2021

Int. J. Med. Sci.

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Background:We investigated the extent of growth of microorganisms with simultaneous administration of lipid emulsions with infusions for Total Parenteral Nutrition (TPN), assuming that the lipid emulsions contaminated with microorganisms are stagnant in a closed-type infusion device. We also investigated if bacterial growth can be prevented in the infusion device by flushing the inside of the infusion device with saline solution after the administration of lipid emulsion from the side tube in vitro setting. Methods: We made a preparation by adding Escherichia coli to the lipid emulsion and started the infusion simultaneously with the infusion solution for TPN and lipid emulsion with the piggyback method. Immediately after the completion of lipid emulsion infusion, we conducted flushing with saline solution. The volume of saline solution was none, 5, 10, or 20 mL at a flow rate of 1 mL/s. Infusion solution that was stagnant in the infusion device was collected immediately before completing the lipid emulsion infusion and 20 h after flushing, i.e., 24 h after starting the infusion for TPN, and the number of viable bacteria was determined. Results: The number of viable E. coli increased in the infusion device of all three species used in this experiment 24 h after starting the lipid emulsion infusion without flushing. We found that bacterial growth could be prevented through flushing with saline solution after the completion of lipid emulsion infusion and flushing out the stagnant infusion solution in the closed-type infusion device. Conclusions: We found that if E. coli was present in the closed-type infusion device, it would multiply. We also found that the number of viable bacteria varied according to the variety and internal structure of the closed-type infusion device as well as the liquid volume used for flushing, although flushing can prevent the growth of microorganisms. Proper management and manipulation of infusion is required to prevent infection.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Microbial growth and importance of flushing inside closed-type infusion devices during administration of lipid emulsion in vitro setting

Omotani¹,

Hatsuda²,

Katsui³

et al. 2021

Int. J. Med. Sci.

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“…Embora existam diretrizes para orientar os cuidados para a manutenção dos CVP (5) , as evidências apontam uma variação nas práticas de enfermagem para prevenção da obstrução, especialmente aquelas acerca do flushing, como volume, frequência e técnica. Na maioria das vezes, essa prática é baseada na política da instituição, na experiência de trabalho pessoal e do colega (2)(3)(11)(12) . De acordo com alguns autores, quando não há padronização no cuidado, os riscos de erros e complicações aumentam consideravelmente (11,13) .…”

Section: Introductionunclassified

“…Na maioria das vezes, essa prática é baseada na política da instituição, na experiência de trabalho pessoal e do colega (2)(3)(11)(12) . De acordo com alguns autores, quando não há padronização no cuidado, os riscos de erros e complicações aumentam consideravelmente (11,13) .…”

Section: Introductionunclassified

Prǭticas de enfermagem relacionadas ao flushing em cateter venoso perifǸrico: estudo descritivo

Braga¹,

Pires²,

Almeida³

et al. 2021

R. Enferm. Cent. O. Min.

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Objetivo: Analisar as prǭticas de enfermagem relacionadas ao flushing para preven��ǜo da obstru��ǜo do cateter venoso perifǸrico. MǸtodo: Estudo descritivo com aplica��ǜo de questionǭrio aos 78 profissionais de enfermagem e checklist durante a observa��ǜo das prǭticas de enfermagem numa cl��nica mǸdica, durante 30 dias. Resultados: 89,7% dos profissionais de enfermagem realizavam o flushing na prǭtica cl��nica. A tǸcnica de pushpause era realizada por 12,86% dos participantes. A seringa mais utilizada foi de 10ml (85,72%), com 10ml de solu��ǜo fisiol��gica 0,9% (52,86%). A tǸcnica push-pause foi realizada em 10,7% das observa��es e a avalia��ǜo da permeabilidade do cateter em 3,6%. Conclusǜo: O flushing Ǹ utilizado para preven��ǜo da obstru��ǜo do cateter nas prǭticas de enfermagem, entretanto, verificou-se diferen��as na tǸcnica, tamanho da seringa, volume de solu��ǜo fisiol��gica utilizada e momentos para realiza��ǜo entre os profissionais e o recomendado pela literatura.

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The flushing procedure in nursing practices: A cross-sectional study with Portuguese and Brazilian nurses

Parreira

Vicente

Bernardes

et al. 2020

Heliyon

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Background In patients with peripheral intravenous catheters (PIVCs), performing flushing is an essential procedure to maintain catheter patency and prevent complications. These PIVC related complications can lead to premature removal and therapeutics interruption, which implies the need of a new catheterization thus increasing patient discomfort and pain. Aims To identify nursing practices related to the flushing procedure, namely: moment(s) of the flushing; the syringe size used; the flush solution, volume and technique; the knowledge and accomplishment of the recommended standards on flushing by nurses. Methods A cross-sectional study was conducted between July and December 2017, with Brazilian and Portuguese nurses. An online questionnaire was developed based on the international recommendations on flushing procedure. Descriptive analysis was performed. Results A total of 76 nurses answered the questionnaire. The majority of nurses (84.2%) performed flushing: the most common technique used was continuous syringe pressure (31.2%), with the push-pause technique being performed by 23.4% of the nurses. Despite the majority performs flushing at four distinct moments (after the PIVC insertion, before, between and after drug delivery), there are inconsistencies in flush solution, volume, and syringe size. The most used volume to perform flushing was 5 mL, filled using normal saline. Despite this, they also recognized the omission of this procedure due to time constrains, no familiarity with the procedure and unavailable material. Conclusions This study identified that flushing procedure isn't always performed by nurses in their clinical practice. Also, several inconsistencies were observed between nurses that performed flushing, reflecting the lack of empirical evidence in this area of research.

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Nurses' Short Peripheral Catheter Flushing Practices: Implications for Patient Care, Nursing Education, and Policy

Cited by 6 publications

References 22 publications

Microbial growth and importance of flushing inside closed-type infusion devices during administration of lipid emulsion in vitro setting

Microbial growth and importance of flushing inside closed-type infusion devices during administration of lipid emulsion in vitro setting

Prǭticas de enfermagem relacionadas ao flushing em cateter venoso perifǸrico: estudo descritivo

The flushing procedure in nursing practices: A cross-sectional study with Portuguese and Brazilian nurses

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