The role of hospital‐based vascular access teams and implications for patient safety: A multi‐methods study

Quinn, Martha; Horowitz, Jennifer K; Krein, Sarah L.; Gaston, Angelique; Ullman, Amanda; Chopra, Vineet

doi:10.1002/jhm.13253

Cited by 3 publications

(1 citation statement)

References 23 publications

(34 reference statements)

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“…This may explain why some patients needed > 4 SPCs. However, despite several studies highlighting the benefits of hospital-based vascular access teams-such as improving staff expertise through training, optimising catheter monitoring and selection, diversifying the use of vascular access devices, promoting awareness of vascular access policies, facilitating up-to-date vascular access training and supporting systematic complication monitoring [32][33][34][35]-it remains uncertain whether specialised vascular access teams outperform the generalist model [36].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Complications related to short peripheral intravenous catheters in patients with acute stroke: a prospective, observational, single-cohort study

Privitera,

Geraneo,

Li Veli

et al. 2024

Intern Emerg Med

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Patients with acute stroke often require venous access to facilitate diagnostic investigations or intravenous therapy. The primary aim of this study was to describe the rate and type of complications associated with the placement of a short peripheral catheter (SPC) in patients with acute ischemic or hemorrhagic stroke. A prospective, observational, single-cohort study was conducted at Niguarda Hospital, Italy, with enrolment in the Emergency Department. Adult patients with an ischemic or hemorrhagic stroke requiring an SPC were enrolled. Complications, such as infiltration, occlusion, phlebitis and dislodgment, were recorded daily. Descriptive statistics were used, and the incidence rate ratio (IRR) was estimated to assess the difference in complications, considering catheter calibre, dominant side, exit site, limb, and limb mobility, ictus type (ischemic/haemorrhagic), impairment deficit (language, motor, visual) and EA-DIVA score. A total of 269 participants and 755 SPC were analysed. Removal of SPC due to at least one local complication occurred in 451 (60%). Dislodgment was the major cause of SPC removal (31%), followed by infiltration (18%), occlusion (6%), and phlebitis (5%). The SPC calibre (22G), exit-site other than antecubital and forearm, visual deficit and EA-DIVA ≥ 8 were associated with a higher rate of SPC complications: IRR, 1.71 [1.31; 2.31]; 1.27 [1.01; 1.60], 1.38 [1.06; 1.80], 1.30 [1.04; 1.64], respectively. No other differences in complication rates were observed according to the insertion site, i.e. dominant side, left side, plegic/hyposthenic limb, or exit site. This study provides novel insights into the frequency and types of complications associated with SPC in patients with acute stroke. Compared to the literature, a higher dislodgment rate was observed, being the first cause of SPC removal, whereas no differences in the number of infiltrations, occlusions, and phlebitis were recorded.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Complications related to short peripheral intravenous catheters in patients with acute stroke: a prospective, observational, single-cohort study

Privitera,

Geraneo,

Li Veli

et al. 2024

Intern Emerg Med

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Effectiveness of a nurse-led peripherally inserted central catheter service: A retrospective cohort study

Alsaleh,

Alosaimi,

Almousawi

et al. 2024

J Vasc Access

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Background: A multitude of challenges arises from the growing utilisation of peripherally inserted central catheters (PICCs), including the ability to provide timely, effective and safe insertion, which must be ensured and prioritised in patient care. A nurse-led model of care has become more prevalent as PICCs become extensively needed due to their applications. However, despite their widespread use, such intervention is yet in its inception in Saudi Arabia, and thereby, evaluating the outcomes of this service is of utmost importance to support patient safety initiatives and quality of care. Purpose: This research aims to assess the effectiveness of a nurse-led PICC placement service. Methods: A quantitative retrospective cohort design was used. The sample of this study was 333 random subsets of records on PICC insertion for adult patients between 1st April 2019 and 31st March 2023 in a tertiary medical facility in Riyadh, Saudi Arabia. Results: A nurse-led PICC service demonstrated an overall successful placement of 330 cases (99.1%), out of which 323 PICCs (97%) were successfully inserted under intra-cavitary electrocardiogram (IC-ECG) guidance, while 7 PICCs (2.1%) were successfully inserted with fluoroscopy. The overall complication rate was 2.35 occurrences per 1000 CL days, whereas the complication rate within the first 10 days after PICC insertion was 0.42 per 1000 CL days. Conclusion: A nurse-led model for PICC insertion has remarkably high success rates and low rates of complication, highlighting the pivotal role of a specialised PICC team. This service boasted a commendable track record of achieving a high rate of success in its implementation, implying that a nurse-led PICC service operates effectively to improve the patient experience by delivering timely and high-quality healthcare service.

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Rapid haemostasis to achieve dressing longevity: evaluation trial results using StatSeal catheter exit site protection

Hastings,

Barton

2024

Br J Nurs

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Peripherally inserted central catheters (PICCs) are vital in delivering intravenous therapy. Despite their advantages, PICCs can lead to complications such as catheter exit site bleeding, which can cause patient distress and increase infection risk. This study evaluated the efficacy of StatSeal, a topical haemostatic device, in managing PICC exit site bleeding. StatSeal uses a hydrophilic polymer and potassium ferrate to form a seal, reducing access site bleeding and minimising dressing changes. For this study, Patients were recruited at Frimley Health NHS Foundation Trust; the trial involved 177 patients with StatSeal, and shows that 99% did not require additional dressing changes within the standard 7-day period. The findings demonstrate StatSeal's effectiveness in improving patient outcomes by reducing exit site bleeding and associated complications, enhancing the efficiency of vascular access maintenance and potentially lowering associated healthcare costs. The trial emphasises the importance of innovative solutions such as StatSeal to advance PICC care and improve patient experience.

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The role of hospital‐based vascular access teams and implications for patient safety: A multi‐methods study

Cited by 3 publications

References 23 publications

Complications related to short peripheral intravenous catheters in patients with acute stroke: a prospective, observational, single-cohort study

Complications related to short peripheral intravenous catheters in patients with acute stroke: a prospective, observational, single-cohort study

Effectiveness of a nurse-led peripherally inserted central catheter service: A retrospective cohort study

Rapid haemostasis to achieve dressing longevity: evaluation trial results using StatSeal catheter exit site protection

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