Journal of Infusion Nursing最新文献

Objective: The aim of this study was to evaluate differences in nurses' ratings of risk factors for difficult intravenous access (DIVA) between oncology infusion unit nurses who perform ≤ 10 insertions compared to > 10 insertions per week.

Methods: An email requesting that recipients complete a revised version of the "Survey on Nurses" perceived DIVA factors that contained a list of 53 risk factors was sent to 152 nurses, of whom 81 responded. Nurses rated each DIVA risk factor, using a 0 (not at all predictive) to 10 (extremely predictive) scale.

Results: Of the 81 nurses who completed the survey, 55.5% and 44.5% performed ≤ 10 insertions versus > 10 insertions per week, respectively. No differences were found between the groups on age, sex, education, or years of experience in nursing or in infusion nursing. Compared to nurses who performed ≤ 10 insertions per week, those who performed > 10 rated only 1 risk factor as more predictive of DIVA (ie, the patient has a history of cirrhosis). Risk factors with the highest DIVA prediction scores were multiple intravenous attempts on the day of treatment, history of multiple venipunctures during previous visits, current or past history of intravenous drug use, and occurrence of dehydration.

Conclusion: Findings can be used to identify high-risk patients and educate oncology nurses.

Central vascular access devices (CVADs) have become an important focus for safe practice in some patients. The aim of this study was to develop a reliable and valid knowledge questionnaire of blood sampling via CVADs for registered nurses by using both classical test theory (CTT) and Rasch analysis. A cross-sectional study was conducted, and the questionnaire was completed by 445 participants. CTT and Rasch analysis were used to measure the psychometric properties of the questionnaire. The final questionnaire consisted of 23 items. CTT analysis revealed acceptable internal reliability with Cronbach's alpha of 0.825 and content validity index (I-CVI = 0.99, S-CVI/UA = 0.925). Rasch analysis was conducted using a dichotomous scale, and the final 23-item questionnaire is unidimensional. The person reliability index was 0.69 with an item reliability index of 0.97. The test-retest reliability was excellent, with an intraclass correlation coefficient of 0.964. This questionnaire demonstrated a unidimensional structure and good psychological properties and was clinically meaningful for registered nurses to test their knowledge of blood sampling via CVADs. The findings represent a useful beginning for further analysis of the questionnaire in larger samples internationally.

Objective: This study assessed the risk factors for thrombosis related to totally implantable venous access ports (TIVAPs) among breast cancer patients.

Methods: A single-center, retrospective, observational study was conducted. Demographic, disease-related, hematological, and TIVAP-related factors were assessed. Multiple logistic regression analysis was used to explore the influencing factors of TIVAP-related thrombosis.

Results: A total of 416 patients with breast cancer with TIVAPs were divided into 3 groups: no thrombosis (64.4%), asymptomatic thrombosis (32.3%), and symptomatic thrombosis (3.3%). Multiple logistic regression showed that with no thrombosis as the reference, the protective factors for asymptomatic thrombosis were chemotherapy and TIVAP placement in the left side of the chest wall. Risk factors were ≤1 comorbidity and the use of ceramics as the base material of the TIVAP reservoir. With no thrombosis as the reference, cancer clinical stage III and chemotherapy were identified as protective factors of symptomatic thrombosis.

Conclusion: Among breast cancer patients with a TIVAP, 32.3% had asymptomatic thrombosis and 3.3% had symptomatic thrombosis. Clinical staff should pay close attention to these indicators and identify high-risk patients with TIVAP-related thrombosis as early as possible.

Vascular access devices (VADs) are essential to intravenous (IV) therapy in acute care. The Centers for Disease Control and Prevention recommends using needleless connectors (NCs) to provide IV access and eliminate the need for needles. Approximately 17 NCs are currently available in the United States, with 3 basic designs. The Infusion Nurses Society Standards of Practice established NC classifications of negative, positive, and anti-reflux NCs. Evidence indicates a relationship between NC fluid displacement, blood reflux, and occlusion. A systematic review of the literature was performed to ascertain whether the functional design of anti-reflux NCs results in reduced catheter occlusion. A literature search of design types, function, and incidence of occlusion complications with peripheral and central venous access devices yielded 24 334 publications, with 61 studies meeting inclusion criteria. Results from available in vitro and in vivo evidence suggest using anti-reflux NCs with the lowest levels of fluid displacement may result in fewer complications of occlusion and longer catheter dwell times. This review correlates current research to update scientific knowledge of NC displacement performance and outcomes of NCs.

Adequate nurse knowledge is imperative to ensure safe blood transfusion practices. This study evaluates the effectiveness of patient blood management (PBM) workshops on improving nurses' knowledge and practices regarding blood transfusions in Shiraz, Iran. Using Kirkpatrick's model, the study assessed reaction, learning, behavior, and results. A total of 562 nurses attended one of 28 6-hour workshops over 4 months. The results showed a high satisfaction among 80.95% of participants. Mean knowledge scores increased significantly after training, from 47.08 to 74.22 out of 100 (P < .001). At 6 months, the mean performance score was 79.31 out of 100. Significant improvements in knowledge and adherence to transfusion protocols were observed. The study underscores the importance of continuous education and evaluation in enhancing transfusion safety.

Adequate venous dilation is important for successful venipuncture and infusion insertion. While the warm compress method is commonly used, its mechanism remains unclear. This study investigated the impact of the warm compress method on blood nitric oxide (NO) concentration, known for its vasodilatory properties. Using a pre-and post-intervention design, participants underwent warm compress application on the non-dominant arm. The blood NO concentration, vein cross-sectional area, and skin temperature were measured pre-and post-intervention. A warm compress was applied at 39 °C to 42 °C for 5 minutes. The skin temperature was measured pre-intervention and after applying pressure with a tourniquet; a vein cross-sectional area image was acquired using ultrasonography, and 2 mL blood was drawn to measure NO. Post-intervention, skin temperature was measured, vein cross-sectional area images were obtained, and blood was similarly collected. Data were analyzed using the Wilcoxon signed-rank sum test. Among the 19 participants (7 men and 12 women; mean age: 42.6 ± 7.5 years), significant differences were observed in skin temperature (32.05 °C versus 39.40 °C), vein cross-sectional area (11.4 mm versus 14.8 mm2), and blood NO concentration (12.45 µmol/L and 11.18 µmol/L) pre- and post-intervention, possibly because the action of blood NO on vascular smooth muscle cells was promoted, leading to blood NO consumption.