{"title":"A new approach for early recognition of peripheral intravenous (PIV) infiltration: a pilot appraisal of a sensor technology in a neonatal population","authors":"M. V. Rens, Kevin Hugill, A. Francia","doi":"10.33235/va.5.2.38-41","DOIUrl":"https://doi.org/10.33235/va.5.2.38-41","url":null,"abstract":"","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77318459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Repositioning a peripherally inserted central catheter (PICC) using a high-flow flush technique (HFFT) in an adult patient with non-Hodgkin’s lymphoma","authors":"Leanne Leanne","doi":"10.33235/va.5.2.49-50","DOIUrl":"https://doi.org/10.33235/va.5.2.49-50","url":null,"abstract":"","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87695763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Whether to remove or retain vascular access devices (VADs) when they are suspected of infection is an important clinical question with no certain answer. This review aims to explore current literature related to removal versus retention of central venous catheters (CVCs) and intra-arterial lines (IALs) suspected of infection in the adult intensive care population. Methods: A narrative review of studies describing management of VADs suspected of infection in the intensive care unit (ICU) was undertaken. After a systematic search, two clinical studies were included in the review. The methodological rigour of these studies was assessed per the Mixed Methods Appraisal Tool (MMAT). Results: The two eligible studies consisted of one randomised control trial and one prospective observational study, including a total of 448 patients. Both studies scored highly on the MMAT, but only pertained to CVCs. No studies relating to other VAD types were identified. No significant differences in outcome were identified between patients whose VADs were removed or retained in the adult ICU cohort, apart from a reduction in number of CVC replacements in patients whose VAD was retained after infection was suspected. Conclusions: There is minimal evidence pertaining to removal versus retention of VADs suspected of infection in the adult ICU patient cohort, and there are limited recommendations specific to suspected infection guiding clinical practice. As a result, VADs may be unnecessarily removed. Further research assessing these important patient outcomes are urgently needed to inform clinical practice.
{"title":"Removal versus retention of vascular access devices (VADs) suspected of infection in the intensive care unit (ICU): a narrative review of the literature","authors":"India Lye, A. Corley, C. Rickard, N. Marsh","doi":"10.33235/va.5.2.42-48","DOIUrl":"https://doi.org/10.33235/va.5.2.42-48","url":null,"abstract":"Background: Whether to remove or retain vascular access devices (VADs) when they are suspected of infection is an important clinical question with no certain answer. This review aims to explore current literature related to removal versus retention of central venous catheters (CVCs) and intra-arterial lines (IALs) suspected of infection in the adult intensive care population.\u0000Methods: A narrative review of studies describing management of VADs suspected of infection in the intensive care unit (ICU) was undertaken. After a systematic search, two clinical studies were included in the review. The methodological rigour of these studies was assessed per the Mixed Methods Appraisal Tool (MMAT).\u0000Results: The two eligible studies consisted of one randomised control trial and one prospective observational study, including a total of 448 patients. Both studies scored highly on the MMAT, but only pertained to CVCs. No studies relating to other VAD types were identified. No significant differences in outcome were identified between patients whose VADs were removed or retained in the adult ICU cohort, apart from a reduction in number of CVC replacements in patients whose VAD was retained after infection was suspected.\u0000Conclusions: There is minimal evidence pertaining to removal versus retention of VADs suspected of infection in the adult ICU patient cohort, and there are limited recommendations specific to suspected infection guiding clinical practice. As a result, VADs may be unnecessarily removed. Further research assessing these important patient outcomes are urgently needed to inform clinical practice.","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74689682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Message from the President","authors":"M. Sutherland","doi":"10.33235/va.5.2.2","DOIUrl":"https://doi.org/10.33235/va.5.2.2","url":null,"abstract":"","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84573455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Webster, G. Ray-Barruel, C. Rickard, N. Marsh, Gabor Mihalia, E. Alexandrou
Objective: The aim of the current study was to map a global picture of the practice of inserting large-bore peripheral intravenous catheters in parturient women. Methods: We analysed a sub-set of data from a prospective, multi-centre, international prevalence study, the One Million Global peripheral intravenous catheter study. The obstetric cohort was drawn from 163 maternity units in 35 countries (1477 women, 1577 catheters) and was collected between 1 June 2014 and 31 July 2015. Clinicians at each of the participating sites collected data using tools that had been previously validated. Results are reported as frequencies and proportions. Results: Overall, 42% of all peripheral intravenous catheters were large bore and of all catheters placed in females in obstetric units, 438 (70%) of these were placed in the hand or wrist. The phlebitis rate was higher in the large-bore group (12%) compared with those with smaller catheters (7%). Only 2% of women received blood products, but it was unclear which catheter was used for this purpose. Conclusion: Large-bore peripheral intravenous catheters are overused for vascular access in parturient women. They are painful and may cause vascular damage. If there is no indication, a catheter should not be placed at all.
{"title":"“Just in case”. Use of large-bore peripheral intravenous catheters in parturient women: A global study","authors":"J. Webster, G. Ray-Barruel, C. Rickard, N. Marsh, Gabor Mihalia, E. Alexandrou","doi":"10.33235/VA.5.1.4-7","DOIUrl":"https://doi.org/10.33235/VA.5.1.4-7","url":null,"abstract":"Objective: The aim of the current study was to map a global picture of the practice of inserting large-bore peripheral intravenous catheters in parturient women.\u0000Methods: We analysed a sub-set of data from a prospective, multi-centre, international prevalence study, the One Million Global peripheral intravenous catheter study. The obstetric cohort was drawn from 163 maternity units in 35 countries (1477 women, 1577 catheters) and was collected between 1 June 2014 and 31 July 2015. Clinicians at each of the participating sites collected data using tools that had been previously validated. Results are reported as frequencies and proportions.\u0000Results: Overall, 42% of all peripheral intravenous catheters were large bore and of all catheters placed in females in obstetric units, 438 (70%) of these were placed in the hand or wrist. The phlebitis rate was higher in the large-bore group (12%) compared with those with smaller catheters (7%). Only 2% of women received blood products, but it was unclear which catheter was used for this purpose.\u0000Conclusion: Large-bore peripheral intravenous catheters are overused for vascular access in parturient women. They are painful and may cause vascular damage. If there is no indication, a catheter should not be placed at all.","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78631014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"President's message\u0000Seeing with new eyes and a fresh perspective","authors":"S. Keogh","doi":"10.33235/VA.5.1.3","DOIUrl":"https://doi.org/10.33235/VA.5.1.3","url":null,"abstract":"","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77157435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Message from the President","authors":"M. Sutherland","doi":"10.33235/va.7.1.3","DOIUrl":"https://doi.org/10.33235/va.7.1.3","url":null,"abstract":"","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77280629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The University Hospitals of Leicester NHS Trust outpatient parenteral antimicrobial therapy (OPAT) service has expanded rapidly with more nurse-led direction. Aims: A retrospective study between 1 July 2014 and 31 December 2019 was undertaken to assess the impact of OPAT expansion on beds released for further utilisation, clinical outcomes, adverse vascular access device (VAD) outcome, and self- and family-administered parenteral antimicrobial therapy. Method: Data were extracted from the OPAT Patient Management System and from a patient questionnaire survey. Findings: 1084 completed patient episodes were recorded in 958 patients, rising from 39 episodes in 2014 to 265 in 2019. The number of beds released for further utilisation correspondingly rose from 828 in 2014 to 8462 in 2019. The proportion of patients/family members trained to self-administer rose from 25% to 75%, with clinical cure/improvement of infection remaining high at between 84.6% and 92.8% of patients annually. Serious adverse VAD events remained low throughout. The patient response was generally positive. Conclusion: Nurse empowerment within OPAT can lead to significant improvements and patient benefits, while maintaining clinical outcomes.
{"title":"Maximising the opportunity of a self‑administration outpatient parenteral antimicrobial therapy pathway","authors":"","doi":"10.5737/cvaa-1511523","DOIUrl":"https://doi.org/10.5737/cvaa-1511523","url":null,"abstract":"Background: The University Hospitals of Leicester NHS Trust outpatient parenteral antimicrobial therapy (OPAT) service has expanded rapidly with more nurse-led direction. Aims: A retrospective study between 1 July 2014 and 31 December 2019 was undertaken to assess the impact of OPAT expansion on beds released for further utilisation, clinical outcomes, adverse vascular access device (VAD) outcome, and self- and family-administered parenteral antimicrobial therapy. Method: Data were extracted from the OPAT Patient Management System and from a patient questionnaire survey. Findings: 1084 completed patient episodes were recorded in 958 patients, rising from 39 episodes in 2014 to 265 in 2019. The number of beds released for further utilisation correspondingly rose from 828 in 2014 to 8462 in 2019. The proportion of patients/family members trained to self-administer rose from 25% to 75%, with clinical cure/improvement of infection remaining high at between 84.6% and 92.8% of patients annually. Serious adverse VAD events remained low throughout. The patient response was generally positive. Conclusion: Nurse empowerment within OPAT can lead to significant improvements and patient benefits, while maintaining clinical outcomes.","PeriodicalId":37355,"journal":{"name":"Vascular Access","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90631220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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