Journal of Infusion Nursing最新文献

Hemodialysis (HD) is a standard procedure for patients with end-stage renal disease, which utilizes arteriovenous fistulas (AVF) and grafts (AVG) for vascular access. Although plastic cannulas are emerging as cost-effective alternatives to traditional metal cannulas, there is limited evidence supporting their use in HD. This systematic review and meta-analysis aimed to compare dialysis adequacy and complications between plastic and metal cannulas for AVF and AVG access. A search identified randomized controlled trials (RCTs) published from 2018 to 2021 that focused on dialysis adequacy as the primary endpoint and vascular complications, such as infiltration and hematoma, as the secondary endpoint. Three studies involving 139 adult patients undergoing HD were included. Pooled analysis indicated that plastic cannulas were associated with a higher dialysis adequacy standardized mean difference (0.43), 95% confidence interval (CI [0.07-0.78]), P = .02, I2 = 0%, and fewer complications (risk ratios = 0.60, 95% CI [0.41-0.88], P = .009, I2 = 0%) than metal cannulas. These findings suggest plastic cannulas may be a more efficient and safer option for HD patients. Further RCTs are warranted to validate these results.

The failure rate of peripheral intravenous catheterization is higher in older adults than in younger adults. Safe peripheral intravenous catheterization requires the veins to be fully dilated to improve palpation. Heat application has been empirically recognized as an effective venous dilation technique. However, evidence is lacking regarding the venous dilation effect of heat application in older adults with degenerated venous walls and impaired endothelial function due to aging. This study aimed to verify the venous dilation effect of heat application before tourniquet use in comparison with tourniquet application in hospitalized older adults (n = 88; mean age: 79.3 ± 8.1 years). Participants underwent 2 conditions on the same day in sequence: the control condition (using a tourniquet) and the heat application condition (applying a hot pack at 40 ± 2 °C for 7 minutes followed by tourniquet use). Measurements pre- and post-intervention included venous diameter, depth, and assessment scores (palpability and visibility). Heat application significantly increased venous diameter, reduced depth, and improved palpability and visibility compared to the control. Additionally, venous palpability improved with heat application in half of the patients whose veins were not palpable after tourniquet application alone. Therefore, heat application is recommended to assess the suitable veins for catheterization in older adults.

This study aimed to assess the knowledge of intravenous therapy among nursing students. A cross-sectional study was conducted with 170 diploma nursing students randomly selected from a private university in Malaysia between November 30 and December 30, 2023. The study found that 90% had moderate knowledge of intravenous therapy. Year 1 nursing students had the lowest knowledge level (52.9%), and medical placement students scored lower than surgical placement students (70.6%). Statistical tests revealed significant associations between knowledge level and year of nursing education (P = .021), current clinical placement (P = .046), and experience in assisting in intravenous therapy (P = .011). The majority of the nursing students were female (88.2%), with 52.4% having surgical placement postings and 78.8% having experience in assisting with intravenous therapy. Nursing education significantly impacts clinical placements (P = < .001), with year 2 nursing students in medical placements assisting more in intravenous therapy than those in years 1 and year 3. Overall, year 3 nursing students in surgical settings had more opportunities in intravenous therapy involvement than students in medical placements. In conclusion, the study highlights the need for intervention to improve nursing students' knowledge of intravenous therapy.

Hyaluronidase-facilitated subcutaneous immunoglobulin (fSCIG) 10% offers potential improvements in patient independence and tolerability versus intravenous immunoglobulin (IVIG) when used for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). fSCIG 10% also requires less frequent infusions and fewer infusion sites than conventional subcutaneous immunoglobulin (subcutaneous immunoglobulin without hyaluronidase). The ADVANCE-CIDP 1 study demonstrated fSCIG 10% efficacy and safety in preventing CIDP relapse and positive responses from patients in terms of satisfaction and treatment preference. Extensive guidance was provided to nurses during the conduct of ADVANCE-CIDP 1, including delivery of a "Train the Trainer" program by clinical trial educators to support study-site nurses. Consequently, ADVANCE-CIDP 1 has generated a valuable source of practical guidance for nurses. This review describes the key role of nursing professionals in facilitating successful transition from IVIG to subcutaneous therapy in patients with CIDP and draws on experience from ADVANCE-CIDP 1 to help equip nursing staff with the knowledge and confidence to support patients with CIDP initiating fSCIG 10% as a maintenance treatment.

Chemotherapy preparation and administration is a complex nursing procedure. Adequate competency and positive behaviors regarding safe handling of cytotoxic drugs is very important for every nurse to ensure patient safety as well as occupational safety. This study assessed the perceived barriers and risks regarding safe handling of chemotherapeutic drugs among nursing personnel of a tertiary care hospital of Delhi, India. A descriptive cross-sectional design was conducted among 60 nursing personnel, who were working in chemotherapy wards and day care units. Self-administered structured questionnaire and rating scales were used for data collection. The sociodemographic and outcome variables were analyzed using descriptive statistics in addition to inferential statistics. The overall mean scores of practice, perceived barriers, and risks of nursing personnel toward safe handling of chemotherapy is 33.26 ± 3.18, 29.75 ± 4.66, and 11.75 ± 2.99, respectively. The most important barrier was inadequate training on chemotherapy and high workload. The highest risk perceived by the nursing personnel was an inadequate regular medical surveillance program, followed by immediate non-replacement of linens soiled with drug spills. It is recommended that chemotherapy safety protocol, safety surveillance systems, and in-service training be instituted for all nursing personnel who are working in an oncology unit.